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From the Columbia-Presbyterian Medical Center (Drs. Hartmann, Conolly, Duong, Prestigiacomo, Joshi, Mohr, and Mast), New York, NY; the Neurologische Klinik (Drs. Hartmann and Mast), Universitätsklinikum Benjamin Franklin, Berlin, Germany; and the Berufsgenossenschaftliche Kliniken der Stadt Halle (Dr. Mast), Bergmannstrost, Halle, Germany.
Address correspondence and reprint requests to Dr. Andreas Hartmann, Stroke Unit, The Neurological Institute, Columbia-Presbyterian Medical Center, 710 West 168th Street, New York, NY 10032.
A 49-year-old woman presenting with recurrent, reversible brainstem symptoms and a distal basilar artery aneurysm underwent balloon test occlusion. Five minutes after balloon inflation she developed a reversible isolated dysarthria. Despite failing the test occlusion (and after an additional brainstem event), the patient underwent surgery with placement of a clip across the basilar artery. The operation was tolerated without complication. The authors conclude that 1) pure dysarthria may be a symptom of temporary basilar artery occlusion and 2) balloon testing may overestimate the risk of basilar artery clipping.
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