{"paper_id":"dc3c88df-d437-4989-b384-953b04b0534c","body_text":"Basilar Artery Thrombosis with Pontine Infarction as the Initial Presentation of Sickle Cell Disease in a Five-Year-Old Girl: A Case Report\nAbstract:\nStroke is a well-known complication of sickle cell disease (SCD), typically involving the anterior circulation. Posterior circulation stroke as the initial manifestation of SCD is rare. This case highlights the diagnostic challenge posed by nonfocal neurological symptomtables in paediatric posterior circulation ischemia. A 5-year-old girl presented with acute onset altered sensorium and reduced responsiveness. Magnetic resonance imaging (MRI) of the brain demonstrated diffusion restriction in the pons. MR angiography (MRA) showed absent opacification of the basilar artery. Laboratory evaluation showed anemia and elevated reticulocyte count, with hemoglobin electrophoresis confirming HbSS genotype. Exchange transfusion was performed, following confirmation of HbSS followed by initiation of hydroxyurea for secondary stroke prevention. The child showed gradual improvement in sensorium, with a modified Rankin Scale score of 3 at discharge. Posterior circulation stroke can be the first manifestation of SCD. Early MRI with MRA and prompt transfusion-based therapy are critical.","source_license":"CC0","license_restricted":false}