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Basilar artery stroke in 81-year-old woman

An 81-year-old woman admitted with arterial hypertension and a left middle cerebral artery bifurcation aneurysm was evaluated at an outside hospital for nausea, dysarthria, headache, and dizziness. She was intubated after exhibiting decreased alertness in the emergency department. Gaze-evoked nystagmus, decreased arousal, and inability to follow commands were noted on examination prior to intubation. She was transferred to our institution for further evaluation and management. MRI and MRA showed right cerebellar, midbrain, bilateral occipital, and pontine tegmentum infarcts from proximal basilar artery thrombosis. (Contributed by Dr. José Biller.)

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