Vertebrobasilar dolichoectasia refers to ectatic and elongated vertebral or basilar arteries, it is usually associated with deterioration of the tunica intima, which causes abnormal vessel distention, atheromatosis and low blood flow velocity that may favor ischemic disease.

There are several etiologic mechanism theories that have been proposed, such as hypertension, atherosclerosis, congenital factors such as autosomal recessive polycystic kidney disease, Fabry disease, Marfan and Ehlers-Danlos syndromes, as well as sickle cell anemia, among others.

It is asymptomatic in many cases, but in symptomatic patients, the clinical manifestations can include a wide variety of neurological deficits, including stroke, brainstem compression syndromes, cranial neuropathies and obstructive hydrocephalus.