Abstract: Science Set Journal of Radiology

Abstract:
The initial evaluation for suspected Top of Basilar Artery Syndrome includes non-contrast CT. On non-contrast CT scans, the presence of hyperdensity in the basilar artery often indicates basilar artery occlusion. This hyper dense basilar artery sign, akin to the hyperdense middle cerebral artery sign seen in anterior circulation strokes, may be the sole finding in an acute presentation and has demonstrated strong predictive value for basilar artery thrombosis, particularly in patients with a high pretest probability of posterior circulation stroke. We report a case of a 60-year-old female patient with cardiovascular risk factors, including diabetes and hypertension, who presented to the emergency department with sudden-onset visual disturbances. A non-contrast CT scan revealed a spontaneously hyperdense appearance in the upper portion of the basilar artery, indicative of basilar artery occlusion, accompanied by bilateral cortico-subcortical temporo-occipital hypodense ischemic areas.