[Clinicopathoradiological studies in 15 cases of megadolichobasilar anomaly].
We clinicopathoradiologically assessed 15 angiographically diagnosed megadolichobasilar anomalies. Nine of the patients were male and 6 were female; their average age was 61 years. Eleven patients presented with cerebral ischemic attacks, other two complained of trigeminal neuralgia and the remaining two suffered severe headaches. Twelve of the patients had severe hypertension. Vertebral angiography revealed marked elongation of the basilar artery with severe tortuousity and dilatation. The average distance from the dorsum sellae to the basilar artery bifurcation on the lateral view was 24.7 mm, and the average maximum diameter of the basilar artery was 8.6 mm. Aneurysmal dilatation of the basilar artery was also observed in four cases. In 14 of the 15 patients CT scans revealed characteristic findings, such as tubular high density mass with evident contrast enhancement extending from the ventral medulla to the interpeduncular cistern. The outcome was extremely poor, with five deaths and four patients with severe dementia. In the two autopsy cases, enlarged internal lumens could be observed despite severe atheroscrelotic changes, such as intimal thickening by atheromas.
Okada
Y
Y
Department of Neurosurgery, Chugoku Rousai Hospital, Kure, Japan.
Shima
T
T
Nishida
M
M
Yamane
K
K
Okita
S
S
Hatayama
T
T
Naoe
Y
Y
Nishida
T
T
D000368:Aged; D001488:Basilar Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000209:etiology; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014277:Trigeminal Neuralgia / Q000209:etiology