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.