Presentation
Altered mental status.
Patient Data
Age: 70 years
Gender: Male
From the case:
Hyperdense basilar tip sign
Frontal
Central line, endotracheal, nasogastric and feeding tubes are appropriately positioned. Lungs clear. Tortuous aorta, heart normal in size, LAD stent.
From the case:
Hyperdense basilar tip sign
Axial non-contrast
Chronic bilateral white matter changes left greater than right. Hyperdense basilar tip sign extending into right posterior cerebral artery.
From the case:
Hyperdense basilar tip sign
Axial C+ arterial phase
Basilar artery thrombus with near total occlusion.
From the case:
Hyperdense basilar tip sign
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Lateral Right vertebral artery
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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