What clinical presentation is characteristic of a basilar infarct?

The characteristic clinical presentation of a basilar infarct is locked-in syndrome. This syndrome typically occurs when there is damage to the pons, which is supplied by the basilar artery. It leads to a specific set of symptoms where there is a complete paralysis of voluntary muscle movement except for eye movements. Patients in locked-in syndrome remain conscious and have intact cognitive function but are unable to speak or move other than their eyes, presenting a profoundly challenging condition both for the patient and their caregivers.

In contrast, complete loss of sensation commonly relates to damage affecting the somatosensory pathways, which may not be specific to basilar infarcts. Exaggerated reflexes can occur in various neurologic conditions but do not uniquely identify a basilar infarct. Hemiplegia with aphasia typically points towards issues with the middle cerebral artery rather than the basilar artery, as these symptoms are more indicative of cortical involvement where speech centers are located. Understanding these distinctions reinforces the unique clinical picture associated with basilar infarcts, with locked-in syndrome being the most specific and representative symptom.