Clinical and imaging characteristics of 11 patients with dissection or dissecting aneurysm involving the basilar artery
| Patient No | Presentation | Preoperative CT and MRI findings | Preoperative DSA findings | Stents |
|---|---|---|---|---|
| 1 | Intermittent headache and vertigo | Brainstem compression, intramural thrombus and intimal flap, no infarction | Tapered narrowing, aneurysm (9.7×7.7 mm) of middle BA, right AICA involved, retention of contrast medium | Leo stent (3.5×25 mm) (×1) |
| 2 | Diplopia, recurrent amaurosis | Intramural thrombus | Double lumen, fusiform dilation of middle–lower BA, bilateral AICA involved | Enterprise stent (4.5×37 mm +4.5×28 mm) (×1) |
| 3 | Blurred vision | Intramural thrombus | Fusiform dilation involving lower BA and bilateral distal VA, right AICA involved, retention of contrast medium | Solitaire stent (6×30 mm) (×4) |
| 4 | Locked-in syndrome | Intimal flap, brainstem infarction | Serpentine dissection involving left distal VA and middle–lower BA, retention of contrast medium | Neuroform stent (4×30 mm) (×2) Wingspan stent (4×20 mm) (×1) Enterprise stent (4.5×37 mm) (×1) |
| 5 | Sudden dizziness, vomiting | Intramural thrombus | Fusiform dilation of entire BA, double lumen | Enterprise stent (4.5×28 mm) (×2) |
| 6 | Right clonic facial spasm | Brainstem compression, intramural thrombus and intimal flap, no infarction | Fusiform aneurysm (9.8×9.7 mm) of BA, retention of contrast medium | Leo stent (5×50 mm) (×1), Enterprise stent (4.5×37 mm) (×1) |
| 7 | Long term headache | Intramural thrombus | Dissection of bilateral distal VA and middle–lower BA, pearl-string sign | Solitaire stent (6×30 mm) (×2) Solitaire stent (6×20 mm) (×1) |
| 8 | Sudden vertigo, coma, alalia, and quadriplegia | Brainstem infarction | Dissection of entire BA, double lumen, retention of contrast medium | Solitaire stent (6×30 mm) (×4) |
| 9 | Sudden dizziness and left weakness | Intimal flap | Dissection of middle–lower BA, double lumen | Solitaire stent (6×30 mm) (×3), Solitaire stent (6×20 mm) (×1) |
| 10 | Incidental finding | Intramural thrombus | Aneurysm (2.0×3.6 mm) of middle BA | Enterprise stent (4.5×37 mm) (×1) |
| 11 | Right hemidysesthesia, drinking cough | Intimal flap, brainstem compression and brainstem infarction | Fusiform aneurysm (15.2×25.6 mm) of lower BA and left distal VA, left PICA involved | Solitaire stent (6×30 mm) (×3) |
Age range of this case series was 30–68 years (mean 51 years); there were 10 men and one woman.
AICA, anterior inferior cerebellar artery; BA, basilar artery; PICA, posterior inferior cerebellar artery; VA, vertebral artery.