Variations in Presentation of Basilar Dolichoectasia: A Case Series

Vertebrobasilar dolichoectasia (VBD) is a vascular anomaly marked by abnormal elongation and dilation of the vertebral and basilar arteries. Often, VBD remains undiagnosed or is discovered incidentally during evaluations of vascular events such as ischemia, hemorrhage, hydrocephalus, or cranial nerve palsies. While most patients are managed conservatively, treatment choices are highly individualized based on clinical presentation, vessel characteristics, and risk factors. We report two cases of VBD identified incidentally following an ischemic stroke and hemifacial spasms. Although the cases share a similar underlying pathology, they exhibit entirely different manifestations, resulting in varied management strategies.