Part 1: Dolichoectasia of the basilar artery: A rare complication

Abstract

Dolichoectatic basilar artery has become a more frequent finding in patients examined with modern neuroimaging techniques. Described complications of basilar dolichoectasia include ischemic infarcts of the brainstem, compression of cranial nerves, and hydrocephalus. We describe a patient who initially presented with pontine ischemic infarct related to dolichoectatic basilar artery. Within several days of her admission, the patient died. Her basilar lesion ruptured, resulting in a devastating subarachnoid hemorrhage, a relatively rare and fatal complication of this condition. We postulate that any deterioration in a patient with dolichoectatic basilar artery should not be automatically attributed to infarct, and that hemorrhage should be considered too.