CONCLUSION

Vertebro-basilar thrombosis has a very high mortality rate. Our patient, who presented in coma secondary to a thromboembolic occlusion of the basilar artery 48 hours in evolution, had a successful recovery after an aggressive multidisciplinary management, which included endovascular recanalization of the occlusion with intra-arterial thrombolysis. This clinical recovery was possible even in the presence of an established pontine infarct. The brain HMPAO SPECT studies were an important aid in estimating the zone of isquemic penumbra and thus helps direct the hemodynamic factors of the medical management.