Transient locked-in syndrome and basilar artery vasospasm.

[locked-in syndrome]

Cerebral vasospasm is the main cause of neurological mortality and morbidity following subarachnoid hemorrhage . Basilar artery vasospasm (BAVS ) is associated with a high morbidity and may have multiple clinical presentations .We report the case of a 43 years -old man with BAVS presenting as a reversible locked-in syndrome (LIS ) after stopping sedation .The symptoms were successfully managed by intra-arterial infusion of vasodilators and balloon angioplasty . Magnetic resonance imaging did not reveal any brainstem lesion 48 h after the complication , demonstrating a hemodynamic mechanism .LIS can reveal BAVS . Its diagnosis relies on clinical examination . In this case , rapid neuro-interventional treatment permitted reversal of symptoms . This could not have been possible under sedation .