A simple collapse, agitation and pathological crying in a young woman? - Atypical onset of a basilar thrombosis

Background—A collapse and agitation in a young person comprises many differential diagnoses, but usually does not include a life-threatening basilar thrombosis. Methods and Results—We report the case of a 19-year old woman who presented mainly with a collapse and agitation. CT and CT-angiography yielded distal basilar thrombosis which was successfully treated by intraarterial thrombolysis. MRI confirmed multiple small ischemic lesions in the vertebrobasilar territory. The patient improved quickly and returned to her normal daily activities of life after a few months. Conclusions—Posterior circulation ischemia should be included among the possible differential diagnoses of any acute onset of an agitated or confusional state. Conflicts of interest/Disclosures—None to declare. Ethics—Written informed consent of the patient has been obtained.