Presentation
Rapidly worsening vertigo and headeache, left upper limb paresthesia and numbness. CNS infarct? Large vessel occlusion?
Patient Data
Age: 70 years
Gender: Male
From the case:
Basilar artery occlusion
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- Basilar artery occlusion.
- Bilateral CCA bifurcation-proximal ICA stenosis, worse on the left.
- Subacute-chronic right ACP and left MCA territory ischemic changes.
- Status post left subclavian artery stent implantation.
- Chronic small vessel ischemic changes (Fazekas II.)
- Incidentaloma: Right upper lobe lung mass depicted partially.
From the case:
Basilar artery occlusion
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The patient underwent urgent endovascular intervention, which was however not successful. The angiograms also demonstrate well the site of occlusion.
Case Discussion
Basilar tip occlusion can be easily missed in the axial plane and is less likely to demonstrate a hyperdense artery sign than MCA thrombi. Careful scrutiny of the thin slice angiographic acquisitions in all imaging planes is crucial.
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