Basilar artery occlusion is a rare, but under-recognised, cause of stroke. This condition has a high mortality and morbidity rate. The basilar artery is formed by the union of the two vertebral arteries and terminates as the posterior cerebral arteries (PCAs). Signs and symptoms will depend on where the occlusion is. Patients frequently will have had preceding posterior circulation TIA symptoms.
There may be:
Bulbar symptoms include:
CT angiography (CTA) is likely to be the most acutely available brain imaging modality.
Patients presenting to the ED with a reduced level of consciousness are likely to be investigated by CT. However, if the diagnosis is suspected early, a CTA request could be made.
These patients have a poor outcome with conservative treatment. Intravenous or preferably intra-arterial thrombolysis or mechanical thrombectomy may be beneficial.