CASE 41: MRI BRAIN

55F with vertigo

IMAGING FINDINGS

Findings reveal the vertebral/basilar artery is elongated, distended and tortuous

It is seen indenting the left pons.

Diagnosis

Vertebro basilar Dolichoectasia

Discussion

Vertebrobasilar dolichoectasia (VBD) is a condition characterized by ectasia, elongation and tortuosity of the basilar artery. It may manifest clinically by compression of the cranial nerves, ischemic symptoms or intracranial bleeding.

The diagnostic criteria for VBD is a basilar artery or vertebral artery diameter >4.5 mm or deviation of any portion of them higher than 10 mm from the shortest expected course, or basilar length >29.5 mm or intracranial vertebral artery length >23.5 mm.VBD is characterized by a high degree of variability in clinical outcome. It is usually asymptomatic and less than 10% of the patients have neurologic symptoms

It may present with varied clinical syndromes like cerebellar dysfunction, ischemic stroke, transient or permanent motor deficits, central sleep apnea, trigeminal neuralgia, hydrocephalus as well as brain stem compression syndrome

Ref:

J Neurosci Rural Pract. 2011 Jan-Jun; 2(1): 6264.