The Analysis Of Clinical Manifestation With30Cases Of The Top Of The Basilar Syndrome

Purpose: To detect the characteristics of risk factors,clinical symptoms, radiology and prognosis of the top of thebasilar syndrome.Method: Patients of TOBS that were admitted to theneurologic department of our hospital (from January2011toDecember2012) were used to conduct this respective study.Statistical analysis was carried out on the clinical data forrisk factors, etiology, clinical symptoms, physical signs,auxiliary examination complication and prognosis of TOBSpatients. Following this, results were compared with thosereported in past documents, and the differences analyzed.Result:(1) The main risk factors of TOBS were identified ashypertension, heart disease, diabetes, hypercholesterolemia,smoking or drinking alcohol, and atherosclerosis, as well asthe medical and family history of cerebrovascular disease. The most likely etiology of TOBS was understood to be arterialembolism.(2) The most common clinical symptoms were weakness oflimbs and dysarthria, with disorders of ocular movement,vertigo, paresthesia, and consciousness disorder followedsuccessively with the main symptoms. Subjective complaints didnot match the neurologic examination thoroughly for somepatients.(3) Various anatomical locations ranged from a frequencyfrom high to low as follows: occipital lobe, cerebellum,thalamus, temporal lobe, midbrain, pons, and splenium of corpuscallosum. It has been established that symptoms and signs maynot match with the radiological lesions.(4) The main complication of TOBS patients was fever,infection of respiratory tract and urinary tract,abnormalities of respiratory and circulatory systems,hypoproteinemia and electrolyte disturbances.(5) During the admission of these patients in hospital,21of the30TOBS patients witnessed improvement, whilst7patients experienced deterioration in their condition, and2 deaths were reported.Conclusion:(1) The most common risk factor of TOBS was hypertension, andthe most common reason was arterial embolism that results fromarteriosclerosis.(2) The main symptoms of TOBS were identified as limbweakness, dysarthria, consciousness disorders, whilstdisorders of ocular movement and abnormality of the pupil wasnot necessarily in diagnosis.(3) Thorough physical examination is necessary whenpatients are presented to hospital and the MRI examination,especially DWI sequence for the head should be done as soon aspossible. DSA should be conducted for the vessels of head andneck if it is possible.(4) It is necessary and important for such patients tohave an adequate supply of daily nutrition and energy, as wellas nursing and recording changes of vital signs for theprognosis of patients.