DWI negative-posterior circulation infarction at 3 hours of the onset of symptoms: vertebrobasilar dolichoectasia combined with thrombosis：A case report and literature review

Objective: The role of the basilar artery morphological abnormalities (BAMA) in the pathogenesis of posterior circulation infarction (PCI) was summarized and analyzed based on the main line of the diagnosis and treatment of the basilar artery excessive bending combined with thrombus formation. The experience and lessons in this process was summarized which could provide reference and warning for further clinical diagnosis and treatment. Methods: This paper described a rare case of DWI-negative PCI 3 hours after onset in a young man as well as its whole process of diagnosis and treatment and the literature of the BAMA was reviewed and summarized. Results: This patient was diagnosed as basilar artery excessive bending combined with thrombosis by CTA, but eventually died of brain stem failure despite receiving intravenous thrombolytic therapy. Conclusion: BAMA should be fully taken into account in the pathogenesis of PCI. The clinical significance of vascular evaluation in patients with PCI and isolated vertigo should be paid enough attention to and the understanding of the clinical significance of the results of this assessment should be broadened in the clinical practice.