Posterior circulation infarct with basilar artery thrombus

Case contributed by Townsville radiology training

Presentation

Found unconscious with fixed, dilated right pupil following ETOH and mixed drug use.

Patient Data

Age: 41 years
Gender: Male

Marked hypodensity of the midbrain and pons and large hypodense regions in the cerebellar hemispheres, more extensive on the right. Effacement of the prepontine cistern and cerebellar sulci due to vasogenic oedema. Hyperdense segment in the basilar artery.

Acute infarction involving the posterior circulation including the brain stem (mid-brain and pons) as seen on CT with interval increase in the degree of obstructive hydrocephalus and development of small intraventricular bleed as well as mild tonsillar herniation.

Complete occlusion of the basilar artery just distal to its formation with occlusion of the P1 segments of bilateral posterior cerebral arteries.

Nuclear medicine

Brain Viability Study

No uptake of isotope.

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Case information

rID: 18363
Case created: 3rd Jul 2012
Last edited: 24th Sep 2015
Inclusion in quiz mode: Included

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