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Basilar artery occlusion — SCE Neurology MCQ

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HardStrokeBasilar artery occlusionSCE Neurology

A patient presents in coma with quadriparesis, preserved vertical eye movements and a distal basilar-artery occlusion on CT angiography. What urgent treatment pathway is indicated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: BImmediate comprehensive-stroke-centre assessment for basilar thrombectomy

The best answer is “Immediate comprehensive-stroke-centre assessment for basilar thrombectomy”. Basilar occlusion can cause a locked-in or comatose presentation. Confirmed large-vessel occlusion requires immediate specialist reperfusion assessment rather than a vague plan for routine secondary prevention. The alternatives “Routine stroke-unit admission without reperfusion assessment”, “Antiplatelet loading followed by outpatient vascular review”, “Elective carotid imaging before treating the basilar occlusion”, “Supportive ventilation while waiting for spontaneous recanalisation” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/