Stroke & Vascular Disorders
Jan. 20, 2022
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A 65-year-old woman presented with acute onset ataxia, headaches, bilateral arm numbness, and binocular diplopia. Examination was remarkable for decreased alertness, bilateral sixth nerve palsies, and bilateral upper limb dysmetria. Presentation after 3 hours prompted catheter cerebral angiography where basilar artery thrombus superior to the anterior inferior cerebellar artery branches was demonstrated. Intraarterial tPA in combination with MERCI (Mechanical Embolectomy Retrieval in Cerebral Ischemia) mechanical thrombectomy restored flow to the remainder of posterior circulation with good clinical outcome. (Contributed by Dr. Tim Malisch and Dr. José Biller.)