Introduction
The prognosis of bilateral pontine infarcts is known to be
poor.1 The basilar artery is the sole arterial supply
to both sides of the pons. If there is an acute basilar artery occlusion
(BAO) that is not recanalised in time, a patient would likely be left
with: quadriparesis; ophthalmoparesis; dysarthria; in the worse case
scenario, lock-in state.1 Patients will generally
receive diffusion weighted imaging (DWI) and an apparent diffusion
coefficient (ADC) score. If these detect an infarction in the brain,
generally it suggests the affected areas are unsalvageable and
irreversible. Currently, treatments using intravenous thrombolytic
agents or intra-arterial treatments for this condition remain unclear of
its efficacy whereas mechanical thrombectomy (MT) is thought to be the
most effective treatment.2 We report a case where a
patient with BAO, whose brain magnetic resonance imaging (MRI) already
showed evidence of restricted diffusion, received mechanical
thrombectomy and had substantial improvement after a year – despite
findings of an intense pontine infarction.