MCQ Neurology Answer 13

There is no homogeneity to the syndromes or prognosis of patients with complete occlusion or severe stenosis of the BA itself. When the occlusive process is gradual and collateral flow is present, the deficits may be focal and survivable. But when onset is sudden and collateral is limited, the syndrome is devastating and usually fatal.

Such patients experience a short prodrome of headache, confusion and dizziness, followed by a rapid progression through stupor to coma. Dysarthria and lateralized paresthesiae are common, as are pupillary and ocular movement abnormalities.

Facial palsy and herniplegia or quadriplegia accompanied by bilateral extensor plantar reflexes are generally seen. Crossed cranial nerve and herniplegia are often manifested during the progression of signs.

Though fluctuations in depth of coma and severity of paralysis often occurs early, death most frequently occurs within days to weeks.

Category: Neurology MCQs