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Basilar artery thrombosis is a rare and potentially fatal cause of posterior circulation stroke. Among the various etiologies, hyperhomocysteinemia is crucial and often under diagnosed, especially in developing countries. Authors describe the case of a 15-year male who presented with 1-day history of headache, vomiting and altered mental status. Non-contrast CT Head revealed multiple acute infarcts in posterior circulation of brain. Laboratory investigations revealed hyperhomocysteinemia.doi:10.18203/2349-3933.ijam20203132 fatcat:mniu5savpnfjvofoni3f4uj3iy