A basilar artery stroke is a stroke affecting the back of the brain. It can occur when the basilar artery, which provides blood to the posterior areas of the brain, becomes blocked or ruptured.

The basilar artery is the main artery at the base of the brain, forming where the two vertebral arteries join. The basilar artery supplies vital oxygen-rich blood to the back of the brain, which includes the brainstem, cerebellum, and thalamus.

A basilar artery stroke is a type of posterior stroke, which affect the back part of the brain.

This article covers the symptoms, causes, and treatment options for a basilar artery stroke. It also looks at how doctors diagnose the condition, the potential complications, a person’s outlook, and methods of prevention.

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A posterior stroke, such as a basilar artery stroke, may cause different symptoms than strokes that affect other areas of the brain.

These symptoms may include:

  • vertigo, which is when the room seems to spin
  • imbalance
  • weakness on one side of the body, such as in an arm or leg
  • slurred speech or difficulty speaking
  • vision problems, such as double vision
  • headache
  • nausea or vomiting

A basilar artery stroke occurs when there is an interruption in blood flow to the brain from a blockage or damage to the basilar artery.

A basilar artery stroke may be ischemic, which means it is due to a blood vessel blockage, or hemorrhagic, which means it is due to a blood vessel rupture.

Narrowing or blockage of the basilar artery may occur due to atherosclerosis or an embolus, such as a blood clot or fatty deposit.

In atherosclerosis, fatty deposits called plaques collect in the arteries. They are the leading cause of ischemic stroke, which may occur due to:

  • a blood clot forming at the plaque in the arteries
  • a blood clot forming in another blood vessel, breaking loose, and traveling through the circulatory system until it reaches a smaller blood vessel and is unable to pass through

Risk factors for a basilar artery stroke include:

When a person arrives at the emergency room for a stroke, doctors will quickly assess the following:

  • the onset of signs and symptoms of stroke
  • blood pressure
  • blood glucose levels
  • use of blood clot prevention medications
  • kidney function
  • medical history

To diagnose a basilar artery stroke, doctors may carry out the following tests:

  • CT scans, which can show whether the stroke is hemorrhagic
  • CT angiogram of the head and neck area, to examine blood vessels
  • MRI scan, to provide detailed images of the brain
  • MRI angiogram, to provide images of the blood vessels

Doctors will first carry out essential testing so they can begin treatment as quickly as possible.

After initial treatment, doctors will carry out more detailed examinations to determine the cause of the stroke, which will help them decide on the best course of treatment. These tests may include:

  • echocardiogram, which is an ultrasound of the heart
  • electrocardiogram, which measures the electrical activity of the heart
  • blood tests
  • carotid ultrasound, which is an ultrasound of the large blood vessels in the front of the neck that take blood from the heart to the brain

Immediate treatment for a basilar artery stroke may consist of medication to dissolve blood clots, such as alteplase or tenecteplase, or a thrombectomy. A thrombectomy is a surgical procedure to remove a blood clot from a blood vessel.

Doctors will monitor people throughout treatment and recovery.

People may need to take antiplatelet medication, which helps prevent blood clots for a period of time following a basilar artery stroke.

The length of time people will need to take antiplatelet medications will depend on the cause and type of basilar artery stroke.

People may then need to take aspirin as a doctor instructs.

Depending on the symptoms of a basilar artery stroke, people may require rehabilitation care as they recover, which may include:

Acupuncture may help reduce vertigo.

With stroke, immediate medical attention is vital for the best outcome.

According to the Centers for Disease Control and Prevention (CDC), people who arrive at the emergency room within the first 3 hours of symptoms appearing usually have less disability after 3 months compared with people who received delayed medical attention.

The outlook of a basilar artery stroke also depends on the severity of the stroke and access to appropriate treatment and care.

Without prompt treatment, basilar artery stroke may be fatal or cause severe neurological problems. With early and proper treatment, the outlook may be good, with minimal adverse effects.

Certain lifestyle and dietary changes may help prevent a basilar artery stroke or prevent a stroke from recurring, such as:

  • eating a Mediterranean diet
  • avoiding or quitting smoking
  • limiting or avoiding alcohol
  • avoiding illegal drugs
  • maintaining healthy blood pressure, cholesterol, and glucose levels
  • staying physically active
  • maintaining a healthy BMI
  • managing any existing health conditions, such as diabetes or heart disease

Potential complications of a basilar artery stroke can result from the stroke itself or from its treatment.

Complications of treatment include:

  • bleeding inside or outside of the skull
  • bleeding at the puncture site
  • reperfusion injury, which is tissue damage that occurs after a return of blood supply to a deoxygenated area
  • hematoma, fistula, or bleeding at the groin puncture site

Stroke can cause permanent complications, such as a hoarse voice and difficulty swallowing.

If stroke results in disability or immobility, a person may experience:

People will need to call 911 if they think they or someone else is having a stroke.

Symptoms of a stroke include:

  • face drooping
  • weakness or numbness on one side of the body
  • slurred speech or difficulty speaking
  • unexplained severe headache
  • sudden confusion
  • vision problems
  • difficulty walking or loss of coordination
  • dizziness

Symptoms of a basilar artery stroke may include:

  • vertigo
  • imbalance
  • double vision
  • nausea or vomiting

Learn more about the symptoms of stroke.

A basilar artery stroke occurs due to a blockage or rupture in the basilar artery, which supplies the back of the brain with blood.

Signs of a basilar artery stroke include vertigo, slurred speech, and weakness on one side of the body. People will require emergency medical attention for a stroke. Prompt treatment may help improve outcomes.