Injury of the basilar artery associated with closed head trauma

The neuropathological findings at necropsy are described in three cases of basilar artery injuries and their consequences after head trauma and the mechanism of injuries is discussed. The first case was that of massive pontine infarct due to an occlusion of the basilar artery trapped in the fracture of the clivus, 13 days before death. The second case, also with a pontine infarct, survived for two and two-thirds months; the trauma was probably similar, but the presence of the basal skull fracture and the occlusion of the basilar artery can be surmised only in retrospect. The third case was one of delayed rupture of the basilar artery occurring three to four weeks after the injury, which caused aneurysmal formation in the left posterior cerebral artery.