Hyperdense basilar tip sign

Case contributed by Stefan Tigges

Presentation

Altered mental status.

Patient Data

Age: 70 years
Gender: Male

Central line, endotracheal, nasogastric and feeding tubes are appropriately positioned. Lungs clear. Tortuous aorta, heart normal in size, LAD stent.

Chronic bilateral white matter changes left greater than right. Hyperdense basilar tip sign extending into right posterior cerebral artery.

Basilar artery thrombus with near total occlusion.

The thrombus of the distal basilar artery nearly completely fills the vessel.

Case Discussion

Basilar artery occlusion is rare but potentially devastating.  A hyperdense basilar tip sign as seen in this case may be present on a non-contrast head CT.

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