Basilar artery thrombosis and Wallenberg syndrome in a patient with uncontrolled hypertension

• Published in: Radiology case reports 2024-08, Vol.19 (8), p.3033-3037
• Main Authors: Dakaj, Nazim, Gocaj, Kaltrina, Kabashi, Serbeze, Dedushi, Kreshnike, Blakaj, Vullnet, Goçaj, Alba
• Format: Article
• Language: English
• Subjects: Basilar dissection; Case Report; Cerebellar signs; Hypertension; Lateral medullary syndrome; Stroke
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2024.03.043

Presented here is a compelling case of a patient with a history of untreated hypertension, highlighting symptoms indicative of Wallenberg syndrome, including acute-onset dizziness, visual disturbances, continuous vomiting, difficulty walking, and an altered level of consciousness. This case's significance lies in its clinical presentation and in the diagnostic journey undertaken to elucidate its underlying pathology. Throughout the patient's hospitalization, a comprehensive assessment incorporating clinical, laboratory, and imaging techniques was conducted to delineate the extent of their condition. Of particular significance were the findings derived from MRI and MRA examinations of the endocranium, which provided crucial insights into the underlying pathophysiology. The MRI revealed multifocal ischemic lesions, pointing towards basilar artery thrombosis affecting both vertebral branches and displaying characteristic features associated with Wallenberg syndrome. Notably, the patient's lack of antihypertensive, anticoagulant, or antiplatelet therapy underscores the importance of addressing modifiable risk factors early in the disease course. This case serves as a poignant reminder of the complexities inherent in cerebrovascular diseases, highlighting the imperative of prompt recognition and management of predisposing factors. By presenting this case, we aim to underscore the clinical significance of timely intervention in mitigating potential complications of hypertension, such as cerebral artery thrombosis, thereby emphasizing the importance of proactive patient care and risk factor modification in clinical practice.