• G Lacroix, D Couret, X Combaz, B Prunet, N Girard, and N Bruder.
• Department of Anesthesiology and Intensive Care, Sainte Anne Teaching Military Hospital, Toulon, France.
• Neurocrit Care. 2012 Feb 1;16(1):145-7.

BackgroundCerebral 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.MethodsWe report the case of a 43 years-old man with BAVS presenting as a reversible locked-in syndrome (LIS) after stopping sedation.ResultsThe 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.ConclusionLIS 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.

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