Pontine stroke - basilar artery stenosis

Case contributed by A.Prof Frank Gaillard

Presentation

Woke with right sided weakness and diplopia.

Patient Data

Age: 65
Gender: Male
CT

CT brain

There no intra- or extra-axial mass lesions, acute haemorrhages or collections. There is a poorly defined low attenuation region within the right side of the pons. 

MRI

MRI brain

There is a focal area of restricted diffusion demonstrated within the left hemi-pons in keeping with an acute infarct.  
CTA demonstrates a high grade stenosis of the basilar artery 10 mm above the vertebral basilar junction. A moderate stenosis is also present at the level of the origin of the left PICA. The right vertebral artery demonstrates only very tenuous flow in the mid-portion of its V4 segment, without convincing flow seen across the vertebral basilar junction, or indeed the V3/V4 junction.
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Case information

rID: 23103
Case created: 22nd May 2013
Last edited: 18th Jul 2017
Inclusion in quiz mode: Included

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