{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:37Z","timestamp":1756425817718,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,4,18]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>Early diagnosis of basilar artery occlusion (BAO) based only on clinical findings is challenging. We present a fully recovered case of BAO caused by pulmonary arteriovenous malformation (PAVM) that was diagnosed early using a protocol for CT angiography (CTA) and promptly treated with endovascular therapy (EVT). A woman in her 50s complained of vertigo with normal level of consciousness (LOC). On arrival, her LOC decreased to a Grass Coma Scale score of 12, and we performed a CT chest-cerebral angiography protocol. Head CTA showed BAO, and an intravenous tissue plasminogen activator was administered, followed by EVT. Chest contrast-enhanced CT showed PAVM in segment 10 of the left lung, which was treated with coil embolisation. For patients with a complaint of vertigo, BAO should be suspected, even if they have an initially normal LOC. A CT chest-cerebral angiography protocol is useful for prompt diagnosis and treatment of BAO and can reveal undetermined causes.<\/jats:p>","DOI":"10.1136\/bcr-2022-253215","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T11:08:41Z","timestamp":1683025721000},"page":"e253215","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["CT chest-cerebral angiography for basilar artery occlusion caused by pulmonary arteriovenous malformation"],"prefix":"10.1136","volume":"16","author":[{"given":"Natsumi","family":"Nakai","sequence":"first","affiliation":[{"name":"Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihisa","family":"Ichiba","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masako","family":"Hata","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Hiroshima, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"2025082802473165000_16.5.e253215.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70229-0"},{"key":"2025082802473165000_16.5.e253215.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70173-5"},{"key":"2025082802473165000_16.5.e253215.3","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-011984"},{"key":"2025082802473165000_16.5.e253215.4","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"2025082802473165000_16.5.e253215.5","doi-asserted-by":"crossref","DOI":"10.1007\/s11940-019-0591-0","article-title":"Basilar artery occlusion: diagnosis and acute treatment","volume":"21","author":"Buchman","year":"2019","journal-title":"Curr Treat Options Neurol"},{"key":"2025082802473165000_16.5.e253215.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2030297"},{"key":"2025082802473165000_16.5.e253215.7","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1161\/CIRCULATIONAHA.121.056554","article-title":"Association between endovascular therapy time to treatment and outcomes in patients with basilar artery occlusion","volume":"145","author":"Joundi","year":"2022","journal-title":"Circulation"},{"key":"2025082802473165000_16.5.e253215.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31179-X"},{"key":"2025082802473165000_16.5.e253215.9","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s11845-018-1888-9","article-title":"Ct cervico-cerebral angiography in acute stroke. can we justify aortic arch imaging?","volume":"188","author":"Sugrue","year":"2019","journal-title":"Ir J Med Sci"},{"key":"2025082802473165000_16.5.e253215.10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.7.959"},{"key":"2025082802473165000_16.5.e253215.11","first-page":"241","article-title":"Pulmonary arteriovenous malformations and risk of stroke","volume":"34","author":"Holzer","year":"2016","journal-title":"Cardiol Clin"},{"key":"2025082802473165000_16.5.e253215.12","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.169.3.3186989"},{"key":"2025082802473165000_16.5.e253215.13","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.087452"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-253215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:47:40Z","timestamp":1756374460000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-253215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":13,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,2]]},"published-print":{"date-parts":[[2023,5]]}},"alternative-id":["10.1136\/bcr-2022-253215"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-253215","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,5]]}}}