Top Of The Basilar Syndrome

Objective: Top of the basilar Syndrome(TOBS) is a special type of vertebral-basilar artery system ischemic disease. The manifestations are complex and severity. Early diagnosis and treatments are very important. We reported two cases of "Top of the basilar" syndrome to illustrate the clinical course and diagnosis problems of this disease . Our aim is to improve recognition and reduce misdiagnosis to TOBS. Methods: A hospital-based, retrospective study was performed. Combining with review of literatures ,we searched the database in our hospital between 2003-2004 and found 2 records diagnosed as TOBS. Result: 1 case was onset as cerebellar infarction, the other was secondary to nephrotic syndrome. Both of the patients suffered conscious disturbance and dyscoria, like the manifestations of cerebral hernia. MR scan display infarcted signs corresponded to theblood-supplied areas of the five arteries on the top of basilar . Conclusions: The manifestations of TOBS are complex . We should watch patients closely during the course of diagnosis and treatments , recheck MRI promptly. If the patients appear transient consciousness disturbance, pupillary and oculomotor abnormalities, we should take TOBS into account. Thrombolysis promptly can make for improve prognosis.