Basilar artery aneurysms are less common than anterior circulation aneurysms, and rupture less frequently, but their critical location necessitates careful evaluation.
- may present as a lobulated hyperattenuating structure anterior to the mid brain
- rupture of a basilar artery aneurysm is typically localised to the interpeduncular cistern, but may extend into the suprasellar cistern
- CT angiography (CTA) provides better evaluation of the aneurysm and its relationship to other branches off the basilar artery
- basilar artery aneurysms can be both fusiform and saccular 2
- better than CTA for evaluating the relationship of the basilar aneurysm with branch vessels off the basilar artery, which is critical when considering intervention
Treatment and prognosis
Both unruptured and ruptured basilar artery aneurysms can be considered for clipping or endovascular coiling.
The type of treatment is tailored to the type of aneurysm (fusiform, saccular, branch, etc).
If coiled, they require close follow-up to ensure complete occlusion, and may require re-treatment 3.
- 1. Chalouhi N, Hoh BL, Hasan D. Review of cerebral aneurysm formation, growth, and rupture. Stroke. 44 (12): 3613-22. doi:10.1161/STROKEAHA.113.002390 - Pubmed
- 2. Serrone JC, Gozal YM, Grossman AW, Andaluz N, Abruzzo T, Zuccarello M, Ringer A. Vertebrobasilar fusiform aneurysms. Neurosurgery clinics of North America. 25 (3): 471-84. doi:10.1016/j.nec.2014.04.006 - Pubmed
- 3. Marlin ES, Ikeda DS, Shaw A, Powers CJ, Sauvageau E. Endovascular treatment of basilar aneurysms. Neurosurgery clinics of North America. 25 (3): 485-95. doi:10.1016/j.nec.2014.04.007 - Pubmed