期刊名称：Aktuelnosti iz Neurologije, Psihijatrije i Graničnih Područja
印刷版ISSN：0354-2726
出版年度：2011
卷号：XIX
期号：1
页码：31-35
出版社：Clinical Center of Vojvodina
摘要：We report a 58- year-old man with personality change, cognitive deterioration and vertigo that gradually progressed over a two-week period. He was diagnosed with subclavian steal syndrome with com-plete reversal of the blood fl ow in the left vertebral artery and the diff erence in the blood pressure between the arms of 45mmHg. During the hospitalization, systolic blood pressure in his left arm was kept over 130mmHg using saline infusions, which lead to the patient's prompt recovery. As other potential causes of acute cerebral syndrome were ruled out, we speculated on subclavian steal as a possible etiological factor. One possibility was thalamic cognitive syndrome. Th e other, in our opinion more likely, was that posterior circulation insuffi ciency compensated from the anterior circulation over the circle of Willis, leading to ante-rior circulation defi ciency which clinically presented as acute cerebral syndrome. Th e slight increase in the systolic blood pressure enhanced the collateral circulation and resulted in a complete recovery. If the patient remained asymptomatic during the further follow-up, and complied with a dietary regimen with higher sa-line and fl uid intake, endovascular treatment would not be necessary. Th is pathophysiological mechanism and the therapeutic approach might make this case unique, since no such cases have been reported in the literature
