Basilar Artery Occlusion: Diagnosis and Acute Treatment

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

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. 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.