Table 1

Summary of the clinical findings and relevant diagnostic studies for each patient

Unit numberSex/age (years)Initial complaints (symptoms)Initial neurological pictureFinal neurological pictureMRAConventional angiographyDeceased
The initial complaints are listed in the order of occurrence and represent the symptoms described by the patient or their relatives. Under initial neurological picture are listed only the abnormal findings on admission.
Bilat, bilateral; L, left; LE, lower extremity; MRA, magnetic resonance angiography; ND, not done; R, right; UE, upper extremity; VII, facial nerve; IX, glossopharyngeal nerve; X, vagus nerve; XI, spinal (accessory) nerve; XII, hypoglossal nerve.
49742M/58Visual complaints, mental changes, “seizure”, “malaise”, altered consciousness, R body weakness, vertigo, speech difficultiesR head deviation, R miosis, L VII paresis, bilat VIII deficit, L X paresis, R Babinski, R LE hemiparesis, sleepinessDeep coma with flaccid quadriplegia and periodic respirationNDNDYes
146976M/33Occipital headacheSee final neurological PresentationLocked-in syndrome with spastic quadriplegia and eye movements only maintained verticallyNDOcclusion of the upper two thirds of the basilar arteryNo
219272M/59Vertigo, frontal headache, vomiting, altered consciousness, speech difficultiesBilat miosis, eye movement abnormalities, nystagmus, bilat VII palsy, bilat Babinski, L UE plegia and bilat LE paresis, sleepinessComa with flaccid quadriplegia, ataxic respiration, and tachycardiaNDNDYes
258466M/59Vomiting, altered consciousness, speech difficulties, R body weakness, abnormal LE movementsR VII palsy, R Babinski, R spastic hemiparesis, R LE myoclonus, L cerebellar ataxia, R hypaesthesia, sleepinessComa with eyes deviated to the R, quadriplegia and extensor posturingNDOcclusion of the basilar artery and L vertebral arteryYes
265666F/52L and occipital headache, intermittent diplopia, unsteady gait, vertigo, hand and feet paraesthesiae, vomiting, “seizure”Horizontal nystagmus, slight L LE paresisComa with spastic quadriplegia, extensor posturing, and apneustic respirationNDNDYes
291011F/80“Malaise”, vertigo, speech difficulties, L body weaknessL VII palsy, L XII paresis, dysarthria, bilat Babinski, L hemiparesis, stuporLocked-in syndrome with flaccid quadriplegia and eye movements maintained only for abduction of R eyeNDNDYes
301435M/56Occipital headache, “malaise”, mental changes, vertigo, vomiting, L body weaknessL VII palsy, bilat IX paresis, L XII paresis, L Babinski, L spastic hemiplegiaComa with spastic quadriparesis, bilat. VII palsy, and bilat. IX-XII paresisNDDistal L vertebral artery occlusion and basilar artery occlusionNo
304046F/33R UE weakness, frontal headache, nausea and vomiting, blurred vision, “malaise”, vertigo, L facial weakness, speech difficulties, “seizure”L VII palsy, L XII paresis, R Babinski, R UE paresis, transient respiratory disturbances, sleepinessLocked-in syndrome with flaccid quadriplegia, eye movements only maintained vertically, extensor posturing, and irregular respirationNDNDYes
318822M/61Bilat LE weakness, R retro-auricular and occipital headache, hearing loss, speech difficultiesEye movement abnormalities, bilat VII palsy, bilat XII paresis, bilat Babinski, quadriplegia, irregular respiration, hypersudationLocked-in syndrome with spastic quadriplegia, eye movements only maintained vertically, and hyperventilationNDNDYes
407078F/76Mental changes, speech difficulties, unsteady gait, diplopiaEye movement abnormalities, horizontal nystagmus, L VII palsy, L XI paresis, bilat. XII paresis, bilat Babinski, R hemiparesis, sleepinessComa with quadriplegia and extensor posturingNDNDYes
444614M/80Occipital headache, unsteady gait, nausea, altered consciousness, speech difficulties, bilat UE paraesthesiaeBilat miosis, eye movement abnormalities, horizontal nystagmus, R VII palsy, R IX-XII paresis, R hemiparesis, R cerebellar ataxia, L hypaesthesia, sleepinessComa with flaccid quadriplegiaNDNDYes
454699M/69“Malaise”, nausea, headache, diplopia, vomiting, altered consciousness, abnormal movements, respiratory disturbances, speech difficultiesEye movement abnormalities, L XII paresis, L Babinski, L hemiplegia, periodic breathing pattern, sleepinessComa with spastic quadriplegia, extensor posturing, and ataxic breathing patternAbsent flow-void in the basilar arteryNDYes
517226M/72Vertigo, tinnitus, R UE weakness, altered consciousness, respiratory disturbancesR VII palsy, R X and XII paresis, bilat Babinski, R hemiplegia and L LE paresisComa with spastic quadriplegia and complete ophthalmoplegiaNDNDYes
546809M/22Mental changes, altered consciousness, unsteady gait, R body weaknessL mydriasis, R VII palsy, horizontal nystagmus, R Babinski, R flaccid hemiparesis, sleepinessL mydriasis, R VII palsy, bilat paresis R >>LNDOcclusion of the upper two thirds of the basilar arteryNo
554272F/58“Malaise”, vertigo, vomiting, diplopia, L hand paraesthesiae, L body weakness, speech difficultiesNystagmus, L VII palsy, L Babinski, L spastic hemiparesis, bilat cerebellar ataxia, L hypaesthesia, sleepinessLocked-in syndrome with flaccid quadriplegia, eye movements only maintained horizontally, and flexor posturingNDOcclusion of the basilar arteryYes
622301M/75“Malaise”, nausea, vomiting, R UE weakness, speech difficultiesBilat miosis, vertical nystagmus, eye movement abnormalities, R facial hypaesthesia, bilat VII palsy, bilat VIII deficit, bilat IX and R XII paresis, R Babinski, R hemiparesis, L hypaesthesia, sleepinessComa with flaccid quadriplegia, extensor posturing, and periodic respirationNDNDYes
634771F/36(Abnormal breathing, no UE or LE movements)See final neurological pictureLocked-in syndrome with spastic quadriplegia and eye movements only maintained vertically downNDOcclusion of the basilar arteryNo
668472M/76L hand weakness, L facial weakness, unsteady gaitL VII palsy, cerebellar ataxiaHorizontal nystagmus, L VII palsy, R VIII deficit, R hyperreflexia with ankle clonus, R LE paresis, L cerebellar ataxiaAbsent flow-void in the basilar artery and L vertebral arteryNDNo
686644M/75“Malaise”, altered consciousness, L body weaknessHorizontal nystagmus, L facial hypaesthesia, L VII palsy, bilat IX paresis, L XI paresis, bilat XII paresis, L Babinski, L flaccid hemiparesis, L hypaesthesia, sleepinessComa with quadriplegiaAbsent flow-void in the basilar arteryNDNo
724519F/58Diffuse L headache, vomiting, mental changes, speech difficulties, L body weaknessL VII palsy, L IX paresis, L Babinski, L UE paresisHorizontal nystagmus, L VII palsy, L IX and X paresis, bilat. Babinski, L hemiplegia and R UE paresisAbsent flow-void in the basilar arteryNDNo
725641M/73Visual disturbances, bilat UE paraesthesiae, breathing difficultiesSee final neurological pictureLocked-in syndrome with flaccid quadriplegia and eye movements only maintained verticallyNDNDYes
758564M/75“Malaise”, visual disturbances, unsteady gait, speech difficultiesBilat miosis, R superior facial hypaesthesia, bitonal voice, R cerebellar ataxiaHorizontal nystagmus, R Babinski, R cerebellar ataxia, L hypaesthesia, sleepinessAbsent flow-void in the basilar artery and R vertebral arteryNDNo
776713F/48“Malaise”, speech difficulties, R body weaknessR VII palsy, bilat Babinski, R spastic hemiplegia, abnormal R hand movementsStupor, erratic eye movements, R XII paresis, bilat Babinski, R hemiplegiaAbsent flow-void in the basilar arteryOcclusion of the basilar arteryNo
781041M/61Occipital headache, unsteady gait, R UE weakness and clumsiness, speech difficulties, R facial weaknessR VII palsy, bilat Babinski, Slight R UE paresis, R cerebellar ataxiaHorizontal nystagmus, R VII palsy, bilat XII paresis, bilat cerebellar ataxia, R hemiparesis, R hypaesthesiaAbsent flow-void in he lower two thirds of the basilar arteryNDNo