Neuroimaging evaluation of non-aneurismatic “top of the basilar” syndrome [Non-Anevrizmatik baziller tepe sendromunda nöroradyolojik değerlendirme]

Purpose: we aim to evaluate the clinical and imaging features of “top of the basilar” syndrome (tob-s). method: we retrospectively evaluated the clinical and imaging features of thirty consecutive tob-s patients. we analyzed the ischemic parenchymal lesions and vascular disturbances with anatomic correlation by using magnetic resonance imaging (mri),diffusion-weighted mri (dwi),computed tomography angiography (cta),magnetic resonance angiography (mra),and digital subtraction angiography (dsa). results: thirty patients (14 males and 16 females) with a mean age of 61 years (range: 32–78 years) were diagnosed as tob-s based on the neuroimaging and clinical findings. large artery atherosclerosis (laa) was the common etiology (63.3%),including the subgroups of in situ steno/occlusive,artery to artery embolus (aa),arterial branch (ab) occlusion,and aa+ab combination. the other etiologies were cardioembolism (ce) (16.6%),arterial dissection (ad) (10.0%),vasculitis (6.6%),and undetermined (3.3%). the patients represented ‘superficial',‘deep' and ‘superficial plus deep' infarcts with segmental,territorial or scattered patterns. the most clinical manifestations were motor deficits,alteration of consciousness,visual/oculomotor disturbance,cerebellar dysfunction,behavioral disorder and speech disorder. conclusion: the accurate evaluation of imaging findings in tob-s is essential for diagnosis and appropriate management. familiarity with the vascular anatomy,supplying territories,and infarction patterns of the ischemic lesions is crucial. © 2016,ege university press. all rights reserved.