Vertebrobasilar dolichoectasia and deep sylvian territory hemorrhage: Any causality? One case report of young man

Dolichoectasia is a pathologic situation in which there is elongation, widening and tortuosity of arteries. It is referred to as a dilatative arteriopathy in which large arteries demonstrate an abnormal connective tissue composition and function. Dilatative arteriopathy involves preferentially the intracranial vertebral and basilar arteries, and less often the carotid and middle cerebral arteries. Vertebrobasilar Dolichoectasia-related intra cerebral hemorrhage remains a real dilemma for researchers due to the insufficient number of studies conducted in this field. Anterior circulation territory, mainly the striatocapsular area, hemorrhage can be seen in VBD patients with or without significant enlargement of its arteries. Our paper demonstrates this true challenge through a young man presenting with a left deep sylvian territory hemorrhagic stroke associated with vertebrobasilar dolichoectasia, without any vascular bed abnormalities in the anterior circulation. We will discuss possible association and causality between vertebrobasilar dolichoectasia and hemorrhagic strokes.