CT ANGIOGRAPHY IN THE DIAGNOSIS OF ACUTE BASILAR OCCLUSION - FIRST RESULTS

Background and purpose: Without recanalisation, acute basilar artery ( BA) occlusion has a mortality of 90%, which is reduced to 50% if recan alisation 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 susp ected acute BA occlusion. Materials and methods: Ten patients with cli nically suspected BA occlusion were examined with conventional CT and spiral CT angiography. Spiral scanning extended from the foramen magnu m to the tip of the basilar artery. For CTA, 130 mi of nonionic contra st media were injected into an antecubital vein. In four patients, tra nsfemoral digital subtraction angiography (DSA) was additionally perfo rmed. All but one patient had a follow-up CT examination the nest day. Results: CTR demonstrated BA occlusion in six patients and a partiall y thrombosed megadolicho-basilar artery in one patient. In four of the sit: patients with CT angiographically diagnosed BA occlusion, an add itional DSA was performed, which confirmed the CTA findings. In three patients the BA showed normal intravasal contrast, and follow-up CT di d not show infarctions in the vertebrobasilar territory. Conclusion: A lthough the number of cases is still small, CTA seems to be a promisin g method for the rapid diagnosis of BA occlusion. It may become a valu able tool for therapy decisions in acute BA occlusions.