Dolichoectasia of the vertebrobasilar artery with partially thrombosed aneurysm
Presentation
Headache. The patient is also known case of abdominal aortic aneurysm.
Patient Data
A hyperdense lesion is noted anterior to the brainstem with a marked mass effect. Mural calcification. Appears continuous with the basilar artery. The right middle cerebral artery is also ectatic.
Cerebral angiography
Dolichoectasia of V4 segment of left vertebral and basilar artery with irregular areas of dilatation.
Partially thrombosed ectatic segment of the V4 segment of left vertebral artery.
Irregular fusiform dilatation of the terminal portion of the right internal carotid artery, M1 segment of right MCA and proximal portion of A1 segment of right ACA.
Absent A1 of the left ACA is noted with rest of the bilateral ACA segments arising from right A1 segment.
Hypoplastic right vertebral artery.
Case Discussion
To be classified as dolichoectasia, in the vertebrobasilar system, the basilar arterial diameter should be great than 4.5 mm.
The patient also had a history of abdominal and thoracic aorta aneurysms diagnosed in the past. The patient presented with altered sensorium in the emergency department and quickly deteriorated before undergoing any treatment.