LAUSR

A man in his 60s presented with impaired level of alertness, convulsive-like movements of the limbs, and vertical nystagmus. Initial imaging findings were consistent with top of the basilar artery occlusion (Figure 1). He received intravenous tissue plasminogen activator and was brought for an attempted endovascular intervention. Thrombectomy was not successful owing to a tortuous vertebral artery, although there was already partial recanalization of the basilar artery from the intravenous tissue plasminogen activator. Subsequent magnetic resonance imaging showed bilateral occipital-temporal, thalamic, and cerebellar