Basilar Artery Thrombosis

Basilar Artery Thrombosis General Details:

• Thrombotic basilar artery occlusion.
• Reported in 2 per 1000 autopsy cases.
• Stroke registries ~ 27% of ischemic strokes occurring in the posterior circulation.

Basilar Artery Thrombosis Clinical Features:

• Coma / decreased consciousness
• Headache
• Locked-in syndrome
• Ocular palsies
• Photopsia - occipital lobe ischaemia)
• Pseudobulbar palsy
• Pupillary palsies
• Quadriparesis
• Vertigo
• Visual disturbance
• Visual loss - occipital lobe ischaemia

Basilar Artery Thrombosis Aetiology:

• Atherosclerotic occlusive disease - esp. mid segment of the basilar artery, followed by the vertebrobasilar junction.
• Embolism - more frequent in the distal 1/3rd of the basilar artery & vertebrobasilar junction.
• Arterial dissection - more common in the extracranial vertebral artery; intracranial dissections very uncommon.

Basilar Artery Thrombosis Investigations:

• MRI or CT angiogram - basilar artery occlusion, either in the proximal portion (top of the basilar syndrome, usually with midbrain and thalamic damage) or more extensively.

Basilar Artery Thrombosis Treatment:

• Thrombolysis - early presentations; with intravenous or intra-arterial recombinant thromboplastin activator (rTPA). 
• Thrombolysis can reverse the ischaemic damage noted, which is often fatal if untreated.

Basilar Artery Thrombosis Prognosis:

• Generally poor prognosis.
• However, some patients may have a limited ischaemic injury associated with an acute partial occlusion or a slow progressive occlusion.

Image: Basilar Artery Thrombosis on CT showing dense basilar artery; thrombolysis catheter and angiogram showing filling defect (Radpod Picture of the Day) (cc)
Tags: Arterial Dissection - Basilar Artery Thrombosis - Embolism - rTPA - Thrombolysis - TPA
Posted by Medicalchemy
Medicalchemy Group: History of Medicine - Images - Mnemonics - Syndromes - Acute Medicine - Anaesthesiology - Anatomy - Anthropology - Biochemistry - Cardiology - Dentistry - Dermatology - Drug ADR - Drugs - Duplication Sites - Embryology - Emergency Medicine - Endocrinology - Epidemiology - Family Medicine - Forensic Medicine - Gastroenterology - Genes - Genetics - Geriatrics - Gynecology - Haematology - Health Informatics - Hepatology - Immunology - Infection - Intensive Care - Medical Dictionary - Medical Education - Medical Geography - Medical Statistics - Metabolic Medicine - Microbiology - Nephrology - Neuroanatomy - Neuroscience - Nuclear Medicine - Nutrition - Obstetrics - Occupational Health - Oncology - Ophthalmology - Orthopaedics - Otolaryngology - Paediatrics - Palliative Care - Parasitology - Pathology - Pharmacology - Physiology - Proteomics - Psychiatry - Public Health - Radiology - Respiratory - Rehabilitation - Rheumatology - Sports Medicine - Surgery - Toxicology - Tropical Medicine - Urology - Vascular - Virology