Basilar Artery Dissection Diagnosed Using Fluid-Attenuated Inversion Recovery and Managed with Stepwise Antithrombotic Therapy: A Case Report.

IF 0.6 Q4 CLINICAL NEUROLOGY

Case Reports in Neurology Pub Date : 2026-02-19 eCollection Date: 2026-01-01 DOI:10.1159/000550934

Monami Dai, Taro Yanagawa, Tatsuki Kimura, Shunsuke Ikeda, Shinichiro Yoshikawa, Tsuyoshi Uesugi, Toshiki Ikeda

{"title":"Basilar Artery Dissection Diagnosed Using Fluid-Attenuated Inversion Recovery and Managed with Stepwise Antithrombotic Therapy: A Case Report.","authors":"Monami Dai, Taro Yanagawa, Tatsuki Kimura, Shunsuke Ikeda, Shinichiro Yoshikawa, Tsuyoshi Uesugi, Toshiki Ikeda","doi":"10.1159/000550934","DOIUrl":null,"url":null,"abstract":"Introduction: Basilar artery dissection (BAD) is a rare cause of brainstem infarction, presenting with nonspecific symptoms and subtle radiographic findings, resulting in diagnostic delays. In this case, we aimed to highlight the value of fluid-attenuated inversion recovery (FLAIR) imaging in the early detection of BAD and evaluate the safety of a stepwise conservative treatment strategy.Case presentation: We report a case of a middle-aged man with an acute brainstem infarction caused by isolated BAD. Initial magnetic resonance imaging revealed diffusion restriction in the pons and linear hyperintensity along the basilar artery on FLAIR imaging. Computed tomography angiogram revealed irregularity of the basilar artery lumen without aneurysmal dilation, which was then confirmed via digital subtraction angiography. The patient was managed conservatively with initial heparinization followed by cilostazol. Results of serial imaging showed no morphological progression, and the patient gradually improved, with only mild residual deficits.Conclusion: This case highlights the diagnostic value of FLAIR imaging in the early detection of BAD and supports the safety and potential efficacy of a stepwise antithrombotic strategy - initial anticoagulation with heparin followed by antiplatelet therapy with cilostazol - in the absence of hemorrhagic risk.","PeriodicalId":9639,"journal":{"name":"Case Reports in Neurology","volume":"18 1","pages":"184-191"},"PeriodicalIF":0.6000,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095197/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000550934","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Basilar artery dissection (BAD) is a rare cause of brainstem infarction, presenting with nonspecific symptoms and subtle radiographic findings, resulting in diagnostic delays. In this case, we aimed to highlight the value of fluid-attenuated inversion recovery (FLAIR) imaging in the early detection of BAD and evaluate the safety of a stepwise conservative treatment strategy.

Case presentation: We report a case of a middle-aged man with an acute brainstem infarction caused by isolated BAD. Initial magnetic resonance imaging revealed diffusion restriction in the pons and linear hyperintensity along the basilar artery on FLAIR imaging. Computed tomography angiogram revealed irregularity of the basilar artery lumen without aneurysmal dilation, which was then confirmed via digital subtraction angiography. The patient was managed conservatively with initial heparinization followed by cilostazol. Results of serial imaging showed no morphological progression, and the patient gradually improved, with only mild residual deficits.

Conclusion: This case highlights the diagnostic value of FLAIR imaging in the early detection of BAD and supports the safety and potential efficacy of a stepwise antithrombotic strategy - initial anticoagulation with heparin followed by antiplatelet therapy with cilostazol - in the absence of hemorrhagic risk.

查看原文本刊更多论文

用液体衰减反转恢复诊断基底动脉夹层并采用逐步抗血栓治疗：1例报告。

基底动脉夹层（BAD）是脑干梗死的一种罕见病因，表现为非特异性症状和细微的影像学表现，导致诊断延迟。在这种情况下，我们的目的是强调液体衰减反转恢复（FLAIR）成像在早期发现BAD的价值，并评估逐步保守治疗策略的安全性。病例介绍：我们报告一例中年男子急性脑干梗死引起孤立的坏。最初的磁共振成像显示脑桥扩散受限，FLAIR成像显示沿基底动脉呈线性高信号。计算机断层血管造影显示基底动脉管腔不规则，无动脉瘤扩张，然后通过数字减影血管造影证实。患者接受保守治疗，初始肝素化治疗，随后服用西洛他唑。连续影像学结果显示无形态学进展，患者逐渐好转，仅残留轻度缺陷。结论：该病例强调了FLAIR成像在早期发现BAD中的诊断价值，并支持了在没有出血风险的情况下，逐步抗血栓策略的安全性和潜在有效性——最初用肝素抗凝，然后用西洛他唑抗血小板治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Case Reports in Neurology Medicine-Neurology (clinical)

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

14 weeks

期刊介绍： This new peer-reviewed online-only journal publishes original case reports covering the entire spectrum of neurology. Clinicians and researchers are given a tool to disseminate their personal experience to a wider public as well as to review interesting cases encountered by colleagues all over the world. To complement the contributions supplementary material is welcomed. The reports are searchable according to the key words supplied by the authors; it will thus be possible to search across the entire growing collection of case reports with universally used terms, further facilitating the retrieval of specific information. Following the open access principle, the entire contents can be retrieved at no charge, guaranteeing easy access to this valuable source of anecdotal information at all times.