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Small basilar artery fenestration mimicking an aneurysm
Hideki Endo1, Hidetoshi Ono2, Hirohiko Nakamura3
1Department of Neurosurgery, Nakamura Memorial Hospital, South 1, West 14, Chuo-ku, Sapporo, 060-8570, Hokkaido, Japan. endo@med.nmh.or.jp.
Surgical and Radiologic Anatomy : SRA
|November 29, 2024
Summary
Basilar artery fenestration, an anatomical variant, can be mistaken for an aneurysm. Careful imaging is crucial to differentiate fenestrations from aneurysms, especially those with varied limb diameters.
Area of Science:
- Vascular Neurology
- Neuroradiology
- Anatomical Variants
Background:
- Fenestration of the basilar artery is a rare congenital anomaly.
- It can be misdiagnosed as other cerebrovascular pathologies, such as arterial dissection or aneurysm.
- Accurate diagnosis is essential for appropriate patient management.
Observation:
- A case of a 41-year-old woman initially suspected of having a basilar artery aneurysm based on 1.5 T magnetic resonance angiography.
- High-resolution 3 T magnetic resonance angiography revealed a basilar artery fenestration, not an aneurysm.
- The fenestration exhibited significant disparity in vessel diameters between its two limbs.
Findings:
- The smaller limb of the fenestration mimicked an aneurysm on initial imaging.
- The anatomical variant presented with one limb maintaining the caliber of the main basilar artery, while the other was markedly smaller and coursed laterally.
- Detailed neuroimaging is critical for distinguishing fenestrations from aneurysms.
Implications:
- Highlights the importance of advanced imaging techniques in diagnosing cerebrovascular variants.
- Emphasizes the need for meticulous evaluation of basilar artery abnormalities to avoid misdiagnosis.
- Contributes to the understanding of fenestration morphology and its potential for diagnostic confusion.
