Locked In Syndrome Case Study

In this case, the patient developed locked in syndrome due the basilar artery thrombosis leading to complete absence of voluntary movement with cognitive function intact.
Locked-in syndrome caused basilar artery thrombosis most commonly related to trauma, vascular, or cardiac malformation, as the basilar remain a major supply of posterior circulation; patient with basilar artery thrombosis commonly presented with sudden and dramatic neurological impairment mostly sudden vertigo, dysarthria, headache and motor deficits such as quadriparesis ,hemiparesis and altered consciousness.

As causes, the most common risk factor is hypertension, hypertension is found to be the reason of 70% of cases. It followed by diabetes mellitus, peripheral vascular disease, coronary artery disease , cigarette smoking, and hyperlipidemia.
A variety of tests may be performed to rule out other conditions. Diagnostic approach CT brain none enhanced is one of first test to be done as in this case as may show hyperdense basilar sign of acute presentation, however it is less sensitive. While enhanced CT show filling defect. CT angiography is the gold stranded and helpful in identifying occluded and dolichoectatic vessels. In addition, angiogram should be used as tool helpful in assisting treatment decision making.
A magnetic resonance angiogram (MRA) as approved can identify vertebral or basilar occlusion as it have sensitivity of as high as 97% and a specificity of as high as