94 yo M presenting with AMS
1. Acute on chronic infarction in the inferior right PICA territory with delayed perfusion in the left PCA territory concerning for vertebrobasilar ischemia.
2. Focal subocclusive thrombus versus dissection at the right V3-V4 junction and additional focus of subocclusive thrombus at the basilar tip involving the left greater than right PCA origin.
3. Additional background of chronic microvascular ischemia with evidence for intracranial atherosclerosis.
(Basilar artery thrombosis)