The 'herald hemiparesis' of basilar artery occlusion
C. M. Fisher
Neurology Service, Massachusetts General Hospital, Boston 02114.
In thrombosis of the basilar artery, not infrequently a hemiparesis is
present at an early stage, when brain-stem signs may be absent or few,
slight or equivocal. It is natural to suspect that such a hemiparesis
signifies localization in a cerebral hemisphere, but unexpectedly in a few
hours bilateral hemiplegia appears associated with coma or a locked-in
syndrome, indicating basilar artery occlusion. I would term this disarming
hemiparesis the "herald hemiparesis" of basilar artery occlusion. If the
true nature of the condition is recognized early, the use of heparin and
other measures may forestall disaster.
