Presentation
Patient woke with vertigo and subsequently (over next hour) developed cranial nerve symptoms (ocular palsies) and decreased level of consciousness.
Patient Data
Age: Elderly
Gender: Male
From the case:
Top of the basilar syndrome
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The top of the basilar artery is hyperdense.
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CTA performed 20 minutes later confirms a filling defect involving the basilar tip and left P1 and SCA origin. The distal PCA fills via the PCOM.
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Despite IV tissue plasminogen activator (tPA), a left superior cerebellar infarct is now visible.
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Follow up CT confirms the evolution of a left-sided superior cerebellar artery infarct with substantial positive mass effect and developing hydrocephalus.