Facharzt FMH Neurologie Practice Questions - Facharzt FMH Für Neurologie Spécialiste FMH En Neurologie Exam

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A 58-year-old woman presents 10 hours after the acute onset of dysarthria, quadriplegia, bilateral horizontal gaze palsy, and fluctuating consciousness (NIHSS 22, pc-ASPECTS 8). CT angiography demonstrates an acute occlusion of the mid-basilar artery. Advanced perfusion neuroimaging confirms extensive salvageable tissue in the brainstem and cerebellum. Based on recent randomized trials (BAOCHE and ATTENTION), what is the definitive recommended treatment?

High-dose intravenous heparin infusion with target aPTT of 70–90 seconds alone Immediate intravenous nimodipine infusion combined with hypervolemic hemodilution therapy Bilateral vertebral artery angioplasty without stent placement or clot retrieval Endovascular mechanical thrombectomy with or without bridging thrombolysis

Correct Answer:

Endovascular mechanical thrombectomy with or without bridging thrombolysis

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