Stroke Imaging Case: Distal Basilar Occlusion with Vertebral Irregularity on CTA and DSA

A 50-year-old with altered mental status had a non-contrast head CT reported as normal. CT angiogram revealed a focal occlusion of the distal basilar artery extending into the right P1 segment, with non-opacification of the proximal left PCA and left vertebral artery. DSA confir…

• Educational case of posterior circulation stroke with 'normal' non-contrast CT, highlighting the need for vascular imaging in unexplained altered mental status.
• CTA shows distal basilar and right P1 occlusion with left vertebral artery occlusion, later clarified by DSA.
• Single de-identified teaching case; findings are not externally validated or generalizable.

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