Successful basilar artery dilatation in pure bilateral cerebral peduncular infarctions using balloon angioplasty

Yutaro Kikuchi; Naoko Miyamoto; Yuki Urushida; Chisato Shimizu; Masakuni Amari; Takeshi Kawarabayashi; Takumi Nakamura; Shin Takatama; Isao Naito; Yoshio Ikeda; Masamitsu Takatama; Mikio Shoji

doi:10.1016/j.ensci.2020.100282

Successful basilar artery dilatation in pure bilateral cerebral peduncular infarctions using balloon angioplasty

eNeurologicalSci. 2020 Oct 10:21:100282. doi: 10.1016/j.ensci.2020.100282. eCollection 2020 Dec.

Authors

Affiliations

¹ Department of Neurology, Isesaki Municipal Hospital, 12-1 Tsunatorihonmachi, Isesaki, Gunma 372-0817, Japan.
² Department of Neurosurgery, Geriatrics Research Institute and Hospital, 3-26-8 Otomocho, Maebashi, Gunma 371-0847, Japan.
³ Department of Neurology, Geriatrics Research Institute and Hospital, 3-26-8 Otomocho, Maebashi, Gunma 371-0847, Japan.
⁴ Department of Neurology, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho,Takasaki, Gunma 370-0829, Japan.
⁵ Department of Neurology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.

Abstract

•An extremely rare case of bilateral cerebral peduncular infarctions (BCPI) is reported.•The detection of the pure Mickey Mouse ears sign on MRI is an indicator of a need for reperfusion therapy.•Severe stenosis of the basilar artery (BA) and a poor collateral supply from both posterior cerebral arteries were seen.•Balloon angioplasty for the BA stenosis ameliorated the stenosis and produced a favorable outcome.

Keywords: BA, Basilar artery; BCPI, Bilateral cerebral peduncular infarctions; Balloon angioplasty; Bilateral cerebral peduncular infarctions; Collateral circulation; DWI, Diffusion-weighted imaging; FLAIR, Fluid-attenuated inversion recovery; HbA1c, Glycated hemoglobin; LDL, Low-density lipoprotein; MRA, Magnetic resonance angiography; MRI, Magnetic resonance imaging; Mickey mouse ears sign; PCA, Posterior cerebral artery; PICA, Posterior inferior cerebellar artery; PcomA, Posterior communicating artery; SCA, Superior cerebellar artery; Vertebrobasilar artery stenosis; mRS, modified Rankin Scale.