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KMID : 0385920170280020213
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Journal of the Korean Society of Emergency Medicine
2017 Volume.28 No. 2 p.213 ~ p.217
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Top of the Basilar Syndrome after 2nd Cervical Spine Fracture
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Kim Sun-Pyo
Sun Kyung-Hoon
Kim Seong-Jung
Kim Tae-Hoon
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Abstract
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Top of the basilar (TOB) syndrome occurs with occlusion of the rostral portion of the basilar artery that supplies blood to the midbrain, thalamus, and temporal and occipital lobes. Symptoms associated with TOB include decreased alertness, abnormal eye movement, dysarthria, and disorders of cerebellar function. A 47-year-old man was transferred to our hospital to manage C2 vertebral fracture sustained in a traffic accident. He was alert on arrival; however, he lapsed into semicoma. He was diagnosed with TOB. Thrombolytic agents could not be administered due to a contraindication in cervical spine fracture. Brain magnetic resonance imaging showed acute infarction of the pons, cerebellum, and posterior cerebral artery territory. This rare case demonstrates that C2 vertebral fracture can result in TOB.
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KEYWORD
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Brain stem infarctions, Spinal fractures, Unconsciousness
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