Advanced Imaging Assessment of Posterior Circulation Stroke Before and After Endovascular Intervention

• Published in: Neurocritical care Vol. 13; no. 3; pp. 407 - 410
• Main Authors: Khan, Asif A., Gatlin, Joseph, Uschmann, Hartmut, Luzardo, Gustavo, Buciuc, Razvan, Khan, Majid
• Format: Journal Article
• Language: English
• Published: New York Humana Press Inc 01.12.2010; Springer Nature B.V
• Subjects: Basilar Artery - diagnostic imaging; Blood clots; Brain Stem - blood supply; Brain Stem - diagnostic imaging; Cerebral Angiography - methods; Critical Care Medicine; Emergency medical care; Humans; Infarction, Posterior Cerebral Artery - diagnostic imaging; Infarction, Posterior Cerebral Artery - surgery; Intensive; Internal Medicine; Ischemia; Male; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neurosciences; Practical Pearl; Stroke; Thrombectomy; Thrombosis; Tomography; Tomography, X-Ray Computed - methods; Veins & arteries; Mismatch; Perfusion-computed tomography; Brainstem; Basilar
• ISSN: 1541-6933; 1556-0961
• DOI: 10.1007/s12028-010-9419-1

Background Perfusion-computed tomography (CTP) is a relatively new technique that allows rapid semiquantitative noninvasive evaluation of cerebral perfusion aiding in the diagnosis of cerebral ischemia and infarction. There is a paucity of data on its application within the posterior circulation, especially, the brainstem. We describe a case of basilar artery thrombosis with cerebellar and brainstem CTP mismatch and discuss possible future applications of CTP for acute posterior fossa circulation and infarction. Methods Case report. Results Successful use of CTP to aid in decision to proceed with neurointervention in acute basilar artery occlusion and confirm its resolution after mechanical clot retrieval. Conclusion Perfusion-computed tomography can successfully be used to define cerebral ischemia and infarction within the posterior fossa and aid in decisions to proceed with neurointervention.