Delayed diagnosis of basilar artery occlusion in a 28-year-old postpartum woman

BMC Neurol. 2024 Dec 4;24(1):471. doi: 10.1186/s12883-024-03927-2.

Abstract

Background: Basilar artery strokes, which are often challenging to diagnose due to their diverse symptoms and uncommon occurrence, demand timely identification to mitigate severe consequences.

Case presentation: This case report discusses a 28-year-old woman who was admitted 7 months postpartum for suspected status epilepticus. Her initial presentation of convulsive activity and encephalopathy prompted an initial differential diagnosis including toxin-related seizures, encephalitis, and serotonin syndrome among others. A CT angiogram revealed nonocclusive basilar artery thrombosis and hypodensities in the basal ganglia and thalamus. MRI revealed additional strokes in the PCA and SCA territories.

Conclusions: The patient's age and recent history of preeclampsia during pregnancy prompted pertinent discussions regarding pregnancy-related strokes. Most importantly, this case sheds light on the diverse presentations of basilar artery strokes and stresses the urgency of swift identification using imaging to avoid significant morbidity and mortality.

Keywords: Basilar artery stroke; Hyperdense basilar artery sign; Preeclampsia; Pregnancy-associated stroke; Stroke in the young.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Computed Tomography Angiography / methods
  • Delayed Diagnosis*
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Postpartum Period*
  • Pregnancy
  • Vertebrobasilar Insufficiency / diagnosis
  • Vertebrobasilar Insufficiency / diagnostic imaging