Dolicoectasia with Basilar Aneurysm

NonContrast CT study of brain and Non contrast 3D TOF MR Brain Angiography show:
Left vertebro basilar Dolico Ectasia.
Basilar mid portion shows a saccular aneurysm with hyperdense thrombus in it.
High riding basilar tip and PCAs.
Dilated both the ICAs cavernous and supra clinoid portion with high riding bifurcation of ICA.

Vertebrobasilar dolichoectasia

Non contrast 3 D TOF Angiogram of brain

VBDE refers to an abnormal elongation, dilatation and tortuosity of the vertebral and basilar arteries.
An anomaly secondary to defective tunica intima and occasionally the tunica media causes weakening of vessel walls resulting in elongation and dilatation of the artery.

Most commonly affects Vertebral Basilar Artery and elderly females.

• Criteria for dolichoectasia of verbrobasilar system, the basilar arterial diameter should be more than 4.5 mm.

Usually asymptomatic.
May present with CN compressions, most commonly affects VII and V CN.
Brain stem compression. Mid brain compression and obstructive hydrocephalus secondary to compression of aqueduct is also reported.