Presentation
Incidental finding, no clinical symptoms, chronic hypertension.
Patient Data
On non-contrast MR imaging, noted dilation and elongation of the basilar artery with a diameter of approximately 7 mm, compressing and deforming the pontine parenchyma, without evidence of ischemic or hemorrhagic complications.
The ventricles and subarachnoid cisterns are within normal limits.
Old hemorrhagic lesion in the left putamen with low signal on SWI.
Lacunar infarct in the right putamen with a rim of hyperintensity on FLAIR (gliosis).
Small vessel white matter disease around both lateral ventricles (Fazekas 1).
Microhemorrhages in the bilateral thalamus with low signal on SWI in chronic hypertensive encephalopathy
Parenchymal atrophy above and below the tentorium cerebelli
Case Discussion
The findings on MR imaging are consistent with vertebrobasilar dolichoectasia, with tortuous dilation (diameter >4.5 mm) and elongation of the basilar artery. Attention should be given to possible complications such as brainstem compression, cerebral ischemia, cerebral hemorrhage, neurovascular compression, and hydrocephalus.
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