Basilar artery fenestration and aneurysms with subarachnoid hemorrhage

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Unconscious collapse.

Patient Data

Age: 60 years
Gender: Female

Hyperdensity inseparable from the prepontine basilar artery, suspicious for aneurysm. A small volume of subarachnoid hemorrhage in the Sylvian fissures and at the vertex as well as a small volume of intraventricular blood in the left trigone.

Incidental bilateral choroid plexus xanthogranuloma.

Basilar artery fenestration with anteriorly (larger) and posteriorly projecting aneurysm at the vertebrobasilar junction. 

DSA confirms basilar artery fenestration and aneurysm. 

Case Discussion

 Basilar artery fenestration is not uncommon and is usually an anatomical variant although there is an increased incidence of cerebral aneurysm.

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