Dolichoectasia of the vertebral basilar and internal carotid arteries: A case report and literature review

Abstract

Background:Dolichoectasia is a rare disorder of the cerebral vasculature consisting of vascular elongation, widening, and tortuosity, usually involving the vertebral and basilar arteries. Its neurological symptoms and signs are highly variable.Case Description:We present a case of dolichoectasia of the vertebrobasilar system in a patient with a long standing history of multiple falls. Repeat neuroimaging revealed an increase in size of the dolichoectatic segment. In addition, a new fusiform dilatation of the contralateral petrous segment of the internal carotid artery and isolated ventriculomegaly had developed.Conclusion:Vertebrobasilar dolichoectasia can cause multiple clinical manifestations, with hydrocephalus being less common. In addition, having dolichoectasia of both posterior and anterior circulation is extremely rare.

Dolichoectasia of the right internal carotid artery diagnosed incidentally by MR angiography in a 17-year-old girl

“…Multiple pathophysiological processes, including prolonged hypertension of the arterial system, might contribute to its development. Histologic studies support the hypothesis of underlying degeneration of the internal elastic lamina and thinning of the media secondary to smooth muscle atrophy [6]. However, in our young patient, congenital weakness of the arterial wall might have contributed to the formation of dolichoectasia [11], [12].…”

“…Dolichoectasia is usually seen in the vertebrobasilar system, can affect the anterior circulation, especially the anterior cerebral artery and its branches [3], [8], and can affect both the vertebrobasilar system and anterior circulation simultaneously [2], [4], [5], [6], [7]. Most patients are aged and hypertensive.…”

“…Ectasia of the cerebral arteries with elongation is rare, most commonly observed in patients who are elderly and those with hypertension, frequently involves the basilar artery followed by the vertebral artery, a condition described as “dolichoectasia of the basilar artery” or “megadolicho basilar artery,” and can involve the anterior circulation, such as the internal carotid artery (ICA) and anterior cerebral artery [1], [2], [3], [4], [5], [6], [7], [8]. In this paper, we use the term “dolichoectasia.”…”

Long segment dolichoectasia of the right internal carotid artery diagnosed by CT angiography

“…Generally described as either “dolichoectasia of the basilar artery” or “megadolicho basilar artery,” we use the term “dolichoectasia” in this paper. The condition can involve the anterior circulation, such as the intracranial segment of the internal carotid artery (ICA) and the anterior cerebral artery [1], [2], [3], [4], [5], [6], and is most commonly observed in patients who are elderly and those with hypertension.…”

Hydrocephalus as a rare compilation of vertebrobasilar dolichoectasia: A case report and review of the literature

“…Its prevalence in the adult population is estimated at 0.06–5.8% and affects most frequently the basilar and vertebral arteries, followed by the internal carotid artery and the middle cerebral artery. [ 1 25 ]…”