Trombosis de la arteria basilar y ventilación mecánica

Abstract

To know the incidence, risk factors, complication and prognosis of the serious thrombosis of the basilar artery. All patients diagnosed as having basilar thrombosis during a 10 year period (1/1/1989 to 31/12/1998) and having been connected to mechanical ventilation in our hospital are retrospectively revised. The following data are analysed: gender, age, risk factors, cause of intubation, days of stay at the intensive care unit and at the hospital, the prognosis at 3 and 6 months and the causes of decease. 62.5% of the 24 found cases were males. The average age among the survivors and the decreased was similar (60.1 +/- 16 and 62 +/- 15.8 years). The most common risk factors were high blood-pressure, atrial fibrillation, diabetes mellitus and smoking. The average stay at the intensive care unit was 11.2 +/- 14.8 days and 31.9 +/- 58.6 days at the hospital. The cause of intubation were: coma, airway protection, cardiorespiratory arrest, general convulsive crisis and respiratory infection. Mortality reached 75% and was caused by progression of coma or infections. Only 16% of them recovered satisfactorily. The patients admitted to hospital in coma, in revived cardiorespiratory arrest and those presenting general convulsive crisis or pneumonia have a higher mortality. Special attention must be drawn towards the appearance of hydrocephalus and infections due to the importance of an early treatment. In patient with a progressive damage of the consciousness level, the airway protection might improve the prognosis.