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Washington University Experience | VASCULAR | Aneurysm - Giant | 1A0 Case 1 History
Case 1 History ---- The patient was a 65 year old man with a six year history of progressive supranuclear palsy (PSP) characterized by progressive micrographia, masked facies, difficulty initiating gait and turning corners, bradykinesia and slight cogwheeling. He had no tremor initially and only slight limitation of up gaze. During his initial workup in the early 1970s an EMI scan and angiogram revealed that he had a surgically unapproachable aneurysm of the left vertebral artery located at the cerebellopontine angle. Available drugs did not stem the steady progression of his neurodegenerative disease. He had difficulty swallowing and developed pneumonia, presumably aspiration in origin. His course was downhill with eventual discharge to a nursing home and death. Autopsy examination showed neurofibrillary tangles, neuron cell loss and gliosis in the substantia nigra, subthalamic nuclei, and globus pallidus most consistent with a diagnosis of PSP.
