Basilar tip aneurysm

Case contributed by Dr Bruno Di Muzio

Presentation

Patient was presented at the ED with a slurred speech and mild right arm weakness.

Patient Data

Age: 64
Gender: Male
CT

CT Brain

10 mm hypodense lesion anteriorly within the left frontal lobe periventricular white matter is compatible with prior small vessel infarction, with mild chronic small vessel ischaemic change noted elsewhere (e.g. superior right frontal subcortical and periventricular white matter).

Demyelination is a much less likely differential in this demographic.

Small cavum septum pellucidum incidentally.

6 x 8 mm basilar tip aneurysm noted.

CT

CTA

CTA Circle of Willis

There is a 8.5 x 7.0 x 6.0 basilar tip aneurysm demonstrating a bilobed consideration. Both P1 segments may be incorporated into the base of the aneurysm.The neck of the aneurysm measures approximately 4.5 mm.

No further intracranial aneurysm or vascular malformation identified.

Annotated image

Arrow demonstrating the basilar tip aneurysm on non-enhanced brain images.  

Case Discussion

This case illustrates a saccular aneurysm at the very end of the basilar artery. A saccular aneurysm is a berry-like outpouching that tend to occur at arterial bifurcations, favouring the anterior circulation (~90%).

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Case information

rID: 35682
Case created: 16th Apr 2015
Last edited: 2nd Nov 2016
Tag: rmh
Inclusion in quiz mode: Included

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