Ventral pontine locked-in syndrome caused by a total occlusion at mid- portion of the basilar artery

We report a patient with complete occulsion of basilar artery and locked-in syndrome, whose magnetic resonance imaging of the brain showed cerebral infarcts at bilateral ventral pons. The ventral pontine locked- in syndrome of this sort is notoriously known to be caused by occulsion of the penetrating pontine branches of basilar artery, and hence a branch vessel disease. However, cerebral angiogram of our specific case showed a total occulsion of the basilar artery at its middle portion beyond the origin of the stenotic anterior inferior cerebellar artery. Other regions, such as the thalamus, mesial temporal lobes, occipital lobes, midbrain, dorsal pons, and cerebellum which were also perfused by basiliar artery and its major branches, were spared the only risk factors of hyperfibrinogenemia ,low HDL- cholesterol level and relatively high hematocrit, and a possible role of hemodynamic change were discussed.#1598