# Early Detection of Hyperdense Basilar Artery Signs Through Comparison With Previous Images

## TL;DR

This case report shows how comparing recent and past CT scans can help detect a sign of artery blockage in stroke patients.

## Contribution

The report introduces the use of quantitative Hounsfield unit measurements to detect hyperdense basilar artery signs in noncontrast CT scans.

## Key findings

- Comparing current and previous CT images helped identify a hyperdense basilar artery sign.
- Quantitative HU measurements showed a significant increase in HU values in the basilar artery.
- Early detection of the HDBA sign via noncontrast CT can expedite diagnosis and treatment of basilar artery occlusion.

## Abstract

The presence of the hyperdense basilar artery (HDBA) sign, which indicates basilar artery occlusion (BAO), plays an important role in the early diagnosis and intervention in patients with acute ischemic stroke. However, qualitative and quantitative assessment of the HDBA sign is challenging. This case report describes a 60-year-old woman with a history of diabetes mellitus, hypertension, and cerebral infarction. She developed progressive loss of consciousness and ataxic respiration. A noncontrast-enhanced head computed tomography (CT) scan performed three hours after symptom onset revealed the HDBA sign compared with previously obtained CT images. Quantitative measurements revealed a significant increase in Hounsfield units (HUs) in the basilar artery. Subsequent three-dimensional CT angiography confirmed the occlusion of the vertebrobasilar artery. This case highlights the importance of comparing current and previous imaging findings in detecting the HDBA sign. Quantitative HU measurements may further aid diagnosis. Early detection of the HDBA sign on noncontrast-enhanced head CT is critical for expediting the diagnosis and treatment of BAO.