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

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. Case report. 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. 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.