[Saccular aneurysm associated with fenestration of the distal segment of basilar artery]

A 32-year-old man who presented with subarachnoid hemorrhage was found to have a saccular aneurysm arising from the proximal end of the fenestration formed at the distal third of basilar artery. The aneurysm dome was directed anteriorly and measured 3mm in diameter. It was successfully clipped via subtemporal transtentorial approach and the patient returned to his previous job. Basilar artery fenestration is angiographically found in 0.23-0.6%. The fenestration is most frequently located in the proximal basilar trunk close to the vertebro-basilar junction. In this report a rare case with an aneurysm associated with fenestration in the distal part of the basilar artery will be presented.