Basilar artery occlusion (BAO) is an uncommon yet devastating cause of posterior circulation stroke, frequently resulting in severe disability or death despite successful reperfusion. We describe a 67-year-old woman with multiple vascular risk factors who presented with acute BAO and was treated with intravenous thrombolysis followed by successful mechanical thrombectomy (Thrombolysis in Cerebral Infarction [TICI] grade 3), with adjunctive Cerebrolysin therapy administered subsequently. Rapid neurological improvement was observed within 24 hours, with the National Institutes of Health Stroke Scale (NIHSS) score decreasing from 7 to 2, followed by complete neurological recovery (NIHSS 0) by day 3. Clinical recovery was sustained throughout the 12-month follow-up period, with only mild residual gait disturbance noted at discharge. No adverse events attributable to Cerebrolysin were observed. Successful reperfusion remains the key determinant of outcome in BAO, and no causal inference can be made regarding Cerebrolysin. This case adds to the limited evidence on the use of Cerebrolysin as an adjunct to reperfusion therapy and supports further investigation in controlled studies of posterior circulation stroke.
