Isolated Basilar Artery Dissection with Ischemic Stroke: Report of 4 Cases

Isolated basilar artery dissection (BAD) is a rare cause of ischemic stroke. Since the clinical presentations and imaging findings could be non-specific and subtle, the diagnosis may be difficult. Here, we presented four cases of isolated BAD with acute ischemic stroke.

Four patients (age, 22 to 57 years) experienced acute onset of hemiparesis and/or vertigo with half of them having initial headache. Acute infarct was noted at pons or thalamus. Three cases needed more than one imaging modality or serial follow-up imaging to confirm a diagnosis of isolated BAD. Vascular tapering and/or false lumen restrictive to basilar artery were the commonest imaging findings. Three of our patients received anticoagulant without recurrent infarct or hemorrhagic complication. All of the patients had good functional outcome with modified Ranking scale scoring 1.

Isolated BAD may cause variable clinical manifestations and the outcome can be favorable. Application of different and advanced imaging studies with serial image follow-up are useful to confirm the diagnosis.