Presentation
Impaired level of consciousness. He is a known case of hypertension.
Patient Data
There is ovoid hyperdense area of blood density measuring 3.4x1.4 cm involving the left lentiform nucleus and external capsule with perilesional edema.
CT angiogram shows fenestration at the origin of the basilar artery, with the two channels converging above the level of left anterior inferior cerebellar artery.
Case Discussion
Typical location of hemorrhage in patient with hypertensive bleed
Patient also had fenestrated basilar artery as incidental finding.
Fenestration is the division of the arterial lumen into distinctly separate channels, each with its own endothelial and muscularis layers, while the adventitia may be shared.
It should be differentiated from complete duplication, where two distinct arteries have separated origins and with no distal arterial convergence.
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