Pseudo XXXX : Case report.

@entity1 @entity154 @entity227 @entity64 @entity850 @entity9085 @entity731 @entity9468 @entity3526 @entity130
INTRODUCTION: @entity9085 ( @entity9085 ) is a condition that results from restricted blood flow to the posterior portions of the brain, which are primarily served by the vertebral and basilar arteries. It is the most common cause of @entity9468 in the elderly and is usually accompanied by @entity227 . @entity154 , @entity731 , @entity64 and/or @entity130 may all lead to decreased vertebrobasilar circulation. A syndrome called @entity3526 ( @entity3526 ), which manifests with similar neurological symptoms but with a different pathophysiology, may also cause @entity9085 . CASE PRESENTATION: A middle-aged female presented with gradual onset fainting and @entity9468 attacks. Cardiac, auditory and autonomic etiologies were investigated and excluded. Clinical findings and presentation were highly suggestive of subclavian steal. However, subsequent CT angiography showed normal subclavian arteries. Instead, findings included a persistent right trigeminal artery (PTA), @entity850 of the right proximal internal carotid artery, atresis of the left vertebral artery and distal segment of right vertebral artery, congenitally compromised changes in vertebral circulation (bilateral absence of the posterior communicating arteries (PCOMs)) and an absent anterograde vertebrobasilar circulation. Symptoms resolved after carotid endarterectomy. DISCUSSION: Due to the absence of a normally developed posterior circulation, the PTA was the main source of blood supply for the @entity1 . Development of recent artheromatous changes in the right internal carotid artery, however, resulted in decreased blood through PTA, further compromising posterior circulation. This resulted in @entity9085 , and manifested in symptomology similar to @entity3526 . CONCLUSIONS: This clinical encounter illustrates the relative contribution of anatomical and vasoocclusive factors in closely mimicking symptoms of @entity3526 .
