Basilar artery occlusion treated with mechanical thrombectomy in extended time window using diffusion-weighted imaging/fluid attenuated inversion recovery mismatch - a case report

Abstract

Introduction. There are individual case reports and case-series in the literature that have applied diffusion-weighted imaging/ fluid attenuated inversion recovery mismatch and intravenous thrombolytic therapy in the treatment of posterior circulation strokes. This case report demonstrates the use of diffusion-weighted imaging/fluid attenuated inversion recovery mismatch in the treatment of basilar artery occlusion with mechanical thrombectomy. Case Report. A 68-year-old male patient presented with a wake-up stroke and a National Institutes of Health Stroke Scale score of 14. Computed tomography angiography showed an occlusion of the basilar artery. Diffusion-weighted imaging/fluid attenuated inversion recovery mismatch was established and mechanical thrombectomy was performed. Complete reperfusion was achieved. Mechanical thrombectomy was performed in the 16th hour from the onset of symptoms. After the intervention, the patient?s National Institutes of Health Stroke Scale score was 9. The patient was discharged without any neurological symptoms and a score of 0 on the modified Rankin Scale. Conclusion. Diffusion- weighted imaging/fluid attenuated inversion recovery mismatch may be a useful criterion for the selection of patients with basilar artery occlusion and unknown-onset strokes who are to be treated with mechanical thrombectomy.