case_images: PMC11798581_01
case_images: a Posterior ASPECT score 9: hypodensity at the left cerebellum. b BATMAN score 6: absence of bilateral PCA, mid and distal basilar artery, and left vertebral artery.
case_images: crn-2025-0017-0001-543218_F01.jpg
case_images: PMC11798581_01_crn-2025-0017-0001-543218_F01.jpg
case_images: F1
case_images: The BATMAN Score was 6, indicating proximal basilar artery and bilateral posterior communicating artery (more than 1 mm) involvement, with left vertebral artery hypoplasia and right vertebral artery dominance (Fig. 1). The patient was immediately referred and transferred to The Medical City (TMC) in Ortigas, Pasig City, Metro Manila, 9.5 h away.
case_images: Four-vessel angiogram showed basilar artery occlusion.
case_images: crn-2025-0017-0001-543218_F02.jpg
case_images: PMC11798581_01_crn-2025-0017-0001-543218_F02.jpg
case_images: F2
case_images: A thrombus in the distal basilar artery (Fig. 2) was identified, prompting mechanical thrombectomy using a Solitaire-X Stent retriever.
case_images: Post-mechanical thrombectomy showed a TICI score of 3.
case_images: crn-2025-0017-0001-543218_F03.jpg
case_images: PMC11798581_01_crn-2025-0017-0001-543218_F03.jpg
case_images: F3
case_images: Complete reperfusion was achieved, resulting in a Thrombolysis in Cerebral Ischemia (TICI) Score of 3 (Fig. 3).
case_images: T1 (a) and T2 (b): subacute ischemic infarction in the posterior and inferior left cerebellar hemisphere and vermis with left tonsillar herniation.
case_images: crn-2025-0017-0001-543218_F04.jpg
case_images: PMC11798581_01_crn-2025-0017-0001-543218_F04.jpg
case_images: F4
case_images: Smaller acute to early subacute ischemic infarcts were present in the left ventral and dorsal pons, left brachium pontis, anterior lobe of the left cerebellar hemisphere, posterior right cerebellar hemisphere, left thalamus, and right inferior parietal lobule, with mild hemorrhagic conversion in the right cerebellar and angular gyrus lesions, as well as a small probably early subacute hemorrhagic infarct in the left superior cerebellum (Fig. 4).