Presentation
Rapidly slipped into a coma.
Patient Data
Non-contrast CT head:
Hyperdense distal basilar artery, signifying a thrombus.
Procedure:
Right femoral puncture and placement of a short 8F sheath.
Findings:
CT at the start of the procedure showed no bleed.
Case Discussion
Lucid and independent individual with well-controlled hypertension.
Upon waking up, the patient told his wife he didn't feel well and could not get up. His consciousness then rapidly deteriorated. Arrived at the ER with a GCS of 4-5.
1.5 hours after waking up, the patient underwent CT-CTA-CTP. The non-contrast CT showed an occluding thrombus in the distal basilar artery but did not show any sign of infarction.
CT perfusion showed reduced flow and preserved or even elevated blood volume throughout the bilateral PCA territory and in the right SCA territory.
He was immediately taken to the catheterization suite, where he underwent a mechanical thrombectomy with full recanalization.
His immediate recovery went surprisingly well.
Unable to process the form. Check for errors and try again.