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Basilar Artery Occlusion: Diagnosis and Acute Treatment

  • Cerebrovascular Disorders (D Jamieson, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review

To provide the latest updates in the diagnosis, management, and prognosis in patients with basilar artery occlusion (BAO).

Recent findings

The diagnosis of BAO requires a high index of suspicion among patients with sudden onset depressed level of consciousness, quadraparesis (or hemiparesis), and cranial nerve dysfunction. Computed topography with angiography is currently the diagnostic modality of choice for the diagnosis of BAO. Given the often catastrophic nature of BAO, intravenous thrombolysis combined with mechanical thrombectomy should be offered in eligible patients. Despite a lack of data from randomized clinical trials, good outcomes are possible, especially in patients without early evidence of infarction.

Summary

Aggressive treatment with intravenous thrombolysis and mechanical thrombectomy should be considered in eligible patients with BAO, but there remains a dearth of information from randomized clinical trials.

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Authors and Affiliations

  1. Department of Neurology, Division of Neurocritical Care, Clinical and Translational Neuroscience Unit, and Department of Neurology, Weill Cornell Medicine, 525 East 68th Street. Room F610, New York, NY, 10065, USA

    Stephanie L. Buchman MD & Alexander E. Merkler MD

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Correspondence to Alexander E. Merkler MD.

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Conflict of Interest

Alexander E. Merkler reports a grant from American Heart Association (Grant number: 18CDA34110419), as well as a grant from Leon Levy Foundation, outside the submitted work.

Stephanie L. Buchman declares no potential conflict of interest.

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Buchman, S.L., Merkler, A.E. Basilar Artery Occlusion: Diagnosis and Acute Treatment. Curr Treat Options Neurol 21, 45 (2019). https://doi.org/10.1007/s11940-019-0591-0

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