The Analysis Of Clinical Manifestation With 30 Cases Of Top Of The Basilar Syndrome

Objective To explore the risk factors,etiology,clinical manifestations,imaging features,complications and prognosis of the top of the basilar syndrome.Methods The clinical data of 30 patients with TOBS who were admitted to the Department of Neurology,First People's Hospital of Yinchuan City from January 2015 to March 2019 were retrospectively analyzed.The clinical data of risk factors,etiology,clinical manifestations,imaging features,complications and prognosis of patients with TOBS were analyzed,and the causes were analyzed.Results 1.The risk factors of TOBS are high to low,followed by hyperlipidemia,hypertension,smoking,hyperhomocysteinemia,heart disease,diabetes,history of previous cerebral infarction,alcohol consumption,hyperuricemia,TIA history.According to TOAST classification,the most common cause of this group of TOBS patients is aortic atherosclerosis.2.The most common clinical manifestation was dyskinesia,followed by speech disorders,vertigo,sensory disturbance,whilst disorders of ocular movement,consciousness disorders,behavioral and cognitive disorders,abnormal pupil,cortical blindness.3.The anatomical parts are cerebellum,occipital lobe,thalamus,temporal lobe,pons,corpus callosum and midbrain which from high to low according to the frequency of disease.4.The main complications in the course of TOBS are infection of respiratory tract,electrolyte disturbances,stress ulcer,acute attack of chronic bronchitis,pyemia and hypoproteinemia.5.Of the 30 patients,25 had a good prognosis,and 5 had a poor prognosis,including 1death.5 of the 30 TOBS patients underwent intravenous thrombolysis,of which 4 patients improved,and 1 died.Conclusion 1.The most common risk factor for this group of patients with TOBS is hyperlipidemia.According to TOAST classification,the most common cause of this group of TOBS patients is aortic atherosclerosis.In the future clinical work should pay attention to strengthen lipid-lowering therapy.2.The clinical manifestations of patients with TOBS are diverse and the diagnosis is relatively difficult.The clinical manifestations of TOBS patients in this group are mainly dyskinesia,and such symptoms should not be ignored in future clinical work.3.TOBS patients should be tested early MRI,DWI,MRA,etc.,early to clear the post-circulation.4.This group of patients has a good effect of intravenous thrombolysis,and early treatment is critical for the prognosis of TOBS.