Outcome in patients with basilar artery occlusion treated conventionally

J Neurol Neurosurg Psychiatry. 2005 Sep;76(9):1238-41. doi: 10.1136/jnnp.2004.049924.

Abstract

Background: Most data on the outcome of basilar artery occlusion are from recent case series of patients treated with intra-arterial thrombolysis. The limited knowledge on the outcome after a conventional treatment approach comes from a few small case series of highly selected patients.

Objective: To provide more data on the outcome of conventional treatment.

Methods: Data were analysed on patients from three centres with symptomatic basilar artery occlusion treated conventionally. Conventional therapy was defined as treatment with antiplatelets, anticoagulation, or both.

Results: Data were available on 82 patients. The case fatality was 40%. Among survivors, 65% remained dependent (Rankin score 4-5). Patients younger than 60 years (odds ratio = 3.1 (95% confidence interval, 1.0 to 9.5)) and those with a minor stroke (OR = 3.1 (1.0 to 9.6)) were more likely to have a good outcome (Rankin score 0-3). Patients with a progressive stroke were less likely to have a good outcome (OR = 0.3 (0.08 to 1.2)) than patients with a maximum deficit at onset or fluctuating symptoms at presentation.

Conclusions: Conventional treatment of symptomatic basilar artery occlusion is associated with a poor outcome in almost 80% of patients, which emphasises the importance of the search for a more effective treatment approach.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Anticoagulants / therapeutic use*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Retrospective Studies
  • Treatment Outcome
  • Vertebrobasilar Insufficiency / drug therapy*

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors