What Is Basilar Artery Stroke?

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Stroke affects nearly 800,000 Americans each year. It is the fifth leading cause of death in the United States. A basilar artery stroke occurs when blood flow to the brain is interrupted. This can happen if the vessel becomes blocked (an ischemic stroke) or ruptured (hemorrhagic stroke).

The basilar artery is located at the base of the brain, where the two vertebral arteries come together. It serves as the main blood supply to the back of the brain, where the occipital lobes, cerebellum, and brainstem are located.

Read on to learn more about the causes, symptoms, and treatment for strokes in the basilar artery.

The brainstem coordinates movement and balance and plays a major role in sleep, digestion, swallowing, breathing, vision, and heart rate. A basilar artery stroke can impact the brainstem, which can be devastating and lead to long-term disabilities or even death.

Basilar Artery Stroke Symptoms

Strokes occur when blood vessels to the brain are blocked or damaged. Nearly 90% of strokes are ischemic; of these, fewer than 5% occur in the basilar artery.

A basilar artery stroke is a type of posterior stroke, which means it affects circulation at the back of the brain. Because the basilar artery supplies blood to the cerebellum, occipital lobes, and brainstem, all of which have different functions, this type of stroke can present in a number of different ways.

Symptoms of a stroke (regardless of type) can include:

  • Severe headache (without a cause)
  • Numbness or weakness in the leg, arm, or face
  • Dizziness, loss of balance, or trouble walking
  • Double vision or loss of vision
  • Loss of coordination
  • Difficulty swallowing
  • Trouble breathing
  • Difficulty speaking or understanding speech
  • Nausea
  • Memory loss
  • Incontinence
  • Headache
  • Sweating

Basilar artery strokes and other posterior strokes can present with many of these symptoms, but the most common are a lack of balance, vertigo, slurred speech, headache, nausea, and vomiting. Though these symptoms can come on suddenly, signs of posterior strokes sometimes come on gradually, or come and go.


There are a number of conditions that can increase your risk of having a stroke. These include:

  • Blood clots
  • Atherosclerosis (hardening of the arteries)
  • Smoking
  • High blood pressure
  • Diabetes
  • Elevated cholesterol levels
  • Rupture of an artery
  • Connective tissue diseases
  • Vasculitis (inflammation of the blood vessels)
  • Previous stroke
  • Neck or spinal cord injury (these can injure blood vessels)
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Strokes that occur in the basilar artery can affect the body functions controlled by the brainstem, cerebellum, and occipital lobes. This makes for significantly varying symptoms—why this type of stroke is difficult to diagnose.

To start, your healthcare provider (or ambulance personnel) will conduct a simple neurological assessment to evaluate your reflexes, motor coordination, and ability to respond to simple commands.

To confirm stroke diagnosis, your doctor will perform a set of tests that could include:

Once your doctor has determined whether or not you've had a stroke, they will conduct additional tests to learn what caused it. They will likely perform blood tests as well as an ultrasound to check to see if your arteries have narrowed. Other tests could include:

  • Echocardiogram: Used to assess the structure and function of your heart
  • Electrocardiogram (ECG/EKG): Used to monitor the rhythm of the heart (could be performed with a portable device called a Holter monitor)


A stroke is a medical emergency and needs to be treated immediately.

Basilar artery strokes are treated like other types of ischemic stroke. The goal is to clear the blockage in the artery. Treatment may include administration of intravenous (IV) tissue plasminogen activator (tPA). This can be an effective way to dissolve the clot, but must be given within three hours of symptoms starting.

Your healthcare provider could also recommend a thrombectomy, a surgical procedure that involves inserting a catheter up to the blocked artery to manually remove the clot. Ideally, this procedure should be performed within six hours of stroke symptoms, but can be beneficial if performed within 24 hours.


While certain risk factors such as age, gender, heredity, and ethnicity are uncontrollable, other conditions are. Taking steps to adjust lifestyle choices can help you control your risk.

You can lower your risk of stroke by:

Your healthcare provider may prescribe blood-thinning drugs to prevent clots. They may also recommend drugs to lower your blood pressure or statins to keep your cholesterol under control.


The basilar artery plays a critical role in supplying blood to regions of the brain like the cerebellum, brainstem, and occipital lobes. If this vessel is compromised in some way, a stroke can occur. A stroke in the basilar artery can be very serious and cause long-term complications. Prevention is key.

A Word From Verywell

A stroke is a medical emergency that requires immediate care. Understanding the symptoms can help you or a loved one minimize the long-term effects of stroke.

If you have known risk factors for stroke, talk to your doctor about how you can lower your risk and improve the health of your blood vessels.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.