[CT angiography in basilar artery thrombosis. Initial experiences].
OBJECTIVE
Without recanalisation, acute basilar artery (BA) occlusion has a mortality of 90%, which is reduced to 50% if recanalisation is achieved. Fast diagnosis of BA occlusion is necessary in order to start thrombolytic therapy without delay. We wanted to assess the role of CT angiography (CTA) in the diagnostic evaluation of suspected acute BA occlusion.


METHODS
Ten patients with clinically suspected BA occlusion were examined with conventional CT and spiral CT angiography. Spiral scanning extended from the foramen magnum to the tip of the basilar artery. For CTA, 130 ml of nonionic contrast media were injected into an antecubital vein. In four patients, transfemoral digital subtraction angiography (DSA) was additionally performed. All but one patient had a follow-up CT examination the next day.


RESULTS
CTA demonstrated BA occlusion in six patients and a partially thrombosed megadolichobasilar artery in one patient. In four of the six patients with CT angiographically diagnosed BA occlusion, an additional DSA was performed, which confirmed the CTA findings. In three patients the BA showed normal intravasal contrast, and follow-up CT did not show infarctions in the vertebrobasilar territory.


CONCLUSIONS
Although the number of cases is still small, CTA seems to be a promising method for the rapid diagnosis of BA occlusion. It may become a valuable tool for therapy decisions in acute BA occlusions.
Erfahrungen
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Abteilung Klinische Neuroradiologie, Universität Heidelberg.
D000208:Acute Disease; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging*