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Basilar trunk artery aneurysm presenting with brainstem stroke.

Rasime P Kavak1, Meltem Özdemir1, Nezih Kavak2

  • 1University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Radiology, Radyoloji Kliniği. Ziraat mah. Şehit Ömer Halisdemir cad. No:20 Altındağ, Ankara, Turkey.

Radiology Case Reports
|February 20, 2020
PubMed
Summary

Basilar trunk artery aneurysms are rare, often affecting 60-year-old males. This case highlights a large chronic mural bleeding ectasia causing fatal brainstem stroke.

Keywords:
AneurysmDolichoectaticFusiformİschemic stroke

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Background:

  • Basilar trunk artery aneurysms are rare intracranial vascular lesions, comprising 2.1% of all aneurysms.
  • Chronic mural bleeding ectasia is the most common subtype, typically diagnosed incidentally in individuals around age 60.
  • These aneurysms are associated with significant morbidity and mortality.

Observation:

  • A 58-year-old male presented with a brainstem stroke.
  • The stroke was attributed to a large chronic mural bleeding ectasia of the basilar trunk artery, measuring 27 mm.
  • The patient experienced a fatal outcome within the first week of admission.

Findings:

  • The presented case involved a basilar trunk artery aneurysm significantly larger than the median diameter (27 mm vs. 11-21 mm).
  • The aneurysm's subtype was chronic mural bleeding ectasia.
  • The patient succumbed to a brainstem stroke secondary to this vascular lesion.

Implications:

  • This case underscores the potential for rapid, fatal neurological deterioration from large basilar trunk artery aneurysms, even in the absence of typical presentation.
  • Early recognition and management of these rare aneurysms are critical due to their high associated risks.
  • Further research into the specific risk factors and optimal treatment strategies for chronic mural bleeding ectasia is warranted.