IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Dolichoectasia of the vertebrobasilar artery with partially thrombosed aneurysm

Case contributed by Bhuwan Bhatta
Diagnosis certain

Presentation

Headache. The patient is also known case of abdominal aortic aneurysm.

Patient Data

Age: 55 years
Gender: Male

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.

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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.