Husband told his basilar artery is 90-99% blocked, should we be more concerned?

[willowsword]

Husband told his basilar artery is 90-99% blocked, but it mustn't be that bad because he has no symptoms,that his brain must be getting the blood somehow. Is this a reasonable train of thought? He has had an angiogram and CT with dye. His cholesterol and blood pressure are normal, and he is not diabetic. Is now on baby aspirin, but they want to put him on Lipitor. He is 64. Reading about the basilar artery, it seems like a massive underreaction. Should we be asking for an MRI? What tests should we be asking for?

[Sara_MHModerator]

Hello and welcome to the forum. We're sure sorry you have to ask that question though.   I can understand your concern and will just say that having a second opinion is never a bad idea.  What prompted the testing that gave you this blockage information?  Neurological symptoms would be expected at that level of blockage.  Please monitor for that.  If he has any of the following, please get immediate help.  Balance difficulty. Vertigo. Double vision or loss of vision. Loss of coordination. Swallowing difficulty. Difficulty pronouncing words. Numbness.  A CT with contrast is good which you've already done and they could try to get more clarity with an MRI.  Are they giving your husband blood thinners?  Are they going to try recanalization?  I can understand your concern. https://radiopaedia.org/articles/acute-basilar-artery-occlusion While it is excellent that he has no symptoms, you don't want to be sitting on a ticking time bomb of a major issue.  Is a second opinion something you feel comfortable you can get?

[willowsword]

Hi. Thank you for answering so quickly. The only reason we know he has this blockage is that he had a bit too much to drink, fell out of bed, and hit his head on the corner of the wall. (He will probably kill me for posting that, but it helps to clarify that it was not the blockage which caused him to stumble. He doesn't drink a lot often, so it hit him a bit hard.) Long story short, he ended up having a CT scan due to hitting his head. No bleeding on the brain, but they did find the stenosis. It is not related. The only possible symptom is that he has gotten pretty severe tinnitus in the last 3 years, which makes it difficult for him to hear. (Could that be a symptom?)

He is the type that he would not be afraid to ask for a second opinion. He has asked for a second (phone - due to Covid) meeting with the neurologist, and we have a running document where we are writing questions he is going to ask. If anyone has suggestions for questions, they would be appreciated.

My biggest question is how is it possible that he is alive and has no symptoms. They say his brain must be getting the blood somehow, but what happens if it becomes 100% blocked? Will that new pathway keep working? Shouldn't they be figuring out if he needs a stent?

I know you cannot give medical advice in a forum, so I'm just looking for good questions to ask the doctors.

[Sara_MHModerator]

Hello,  I wanted to circle back and see how things are going?  Any more discussion with his doctor.  I think I'd want to move on this sooner rather than later and I think the questions you had are good ones to ask.  Please give me an update.