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Clinical and Imaging Manifestations of the Top-of-the-Basilar Artery Syndrome

PU Jie,LI Hong-hua,CHEN Wen-Jun,CUI Min,WU Fei.Department of Neurology,Wuhan General Hospital of Guangzhou Military Region,Wuhan 430070,China  
Objective:Clinical manifestation and imaging abnormalities of the top-of-the-basilar artery syndrome(TOBS)have been summarized.Methods:Clinical data of 16 patients with TOBS were reviewed retrospectively.Results:Cerebral thrombosis and cerebral embolism were the major cause of TOBS.The clinical manifestation included conscious disturbances,ocular movement disorders,pupillary disorders and paralysis.Computerized tomography(CT)was insensitive for acute infarction.Diffusion weighted imaging(DWI)demarcated the lesions of infarction in patients with TOBS.Magnetic resonance angiography(MRA)clearly visualized the vertebral arteries,basilar artery and posterior cerebral arteries.Conclusion:Diagnosis of TOBS depends on clinical presentation and imaging changes.Magnetic resonance imaging(MRI),especially DWI,is superior to CT in early diagnosis of TOBS.
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