Internal and Emergency Medicine

, Volume 13, Issue 8, pp 1327–1328 | Cite as

Beware the bright basilar artery: an early and specific CT sign of acute basilar artery thrombosis

  • Mougnyan CoxEmail author
  • Dong Kim
  • Neda Isabel Sedora-Roman
  • Robert Hurst
  • Bryan Pukenas


A 74-year-old man was emergently transported to the emergency room after an episode of witnessed unresponsiveness. One day prior to admission, he was complaining of malaise, headaches, and vomiting to family members. His symptoms progressively worsened, but he did not seek immediate treatment. He was brought in by family after becoming increasingly drowsy and eventually unresponsive. His past medical history was notable for hypertension and atrial fibrillation. He was not on anticoagulation.

In the Emergency Department (ED), he was unresponsive to deep sternal rub and was intermittently posturing, and both his pupils were 5 mm and unreactive bilaterally. He was intubated, and taken immediately to the CT scanner for neuroimaging. His noncontrast CT scan was notable only for a hyperdense basilar tip (arrow in Fig.  1). No intracranial hemorrhage or parenchymal abnormality was seen on the head CT. No intravenous tPA was given, as he was several hours out of the time window for...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Mattle HP, Arnold M, Lindsberg PJ, Schonewille WJ, Schroth G (2011) Basilar artery occlusion. Lancet Neurol 10(11):1002–1014CrossRefGoogle Scholar
  2. 2.
    Schonewille WJ, Wijman CA, Michel P, Rueckert CM, Weimar C, Mattle HP, Engelter ST, Tanne D, Muir KW, Molina CA, Thijs V (2009) Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol 8(8):724–730CrossRefGoogle Scholar

Copyright information

© SIMI 2018

Authors and Affiliations

  • Mougnyan Cox
    • 1
    Email author
  • Dong Kim
    • 2
  • Neda Isabel Sedora-Roman
    • 3
  • Robert Hurst
    • 3
  • Bryan Pukenas
    • 3
  1. 1.Division of Neuroradiology, Department of RadiologyHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Division of Neuroradiology, Department of RadiologyMayo ClinicRochesterUSA
  3. 3.Section of Interventional Neuroradiology, Division of Neuroradiology, Department of RadiologyHospital of the University of PennsylvaniaPhiladelphiaUSA

Personalised recommendations