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March 1985

'Top of the Basilar' Artery Stroke in an Adolescent With Down's Syndrome

Author Affiliations

From the Departments of Neurology and Pediatrics, Baylor College of Medicine, Houston; and the Neurology Service, Texas Children's Hospital, Houston.

Arch Neurol. 1985;42(3):296. doi:10.1001/archneur.1985.04060030118022

Basilar artery strokes are rare in children and adolescents.1 DeVivo and Farrell, summarizing the world's literature up to 1972, found only five cases and added one of their own patients.2 In all cases there appeared to be no predisposing causes or abnormalities of the posterior fossa vessels. The coexistence of Down's syndrome and vertebrobasilar strokes has not, to our knowledge, been reported. Down's syndrome is associated with cardiac malformations (mainly atrioventricular canal) that may lead to embolic strokes, and atlantoaxial dislocation that may also result in neurologic dysfunction. We have encountered a patient with trisomy 21 syndrome (without cardiac disease or atlantoaxial dislocation) who presented with classical clinical and computed tomographic evidence of a "top of the basilar" artery stroke.

REPORT OF A CASE  A 16-year-old youth with trisomy 21 syndrome was in his usual state of health when he suddenly staggered and collapsed, falling to the right.

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