Basilar Artery Dissection Complicated with Infective Endocarditis

Thrombectomy in acute basilar artery dissection: A case report

A 34-year-old patient was admitted with unclear coma and stretch synergisms. CT-imaging was strongly suspicious of basilar artery dissection, this was confirmed on subsequent DSA. The patient was lysed and a complex thrombectomy was performed. Despite sufficient recanalization, the patient unfortunately died shortly after. To the best of our knowledge, this is the first description of an acute basilar artery dissection treated by thrombectomy.

Congenital and acquired anomalies of the basilar artery: A pictorial essay

INTRODUCTION

The basilar artery is one of the two cases in our body where an arterial vessel is formed by the union of two others - the vertebral arteries. It provides vascular supply to essential structures for the main vital functions; the posterior cerebral arteries originate from it as terminal branches, and form part of the anastomotic circle of Willis.

IMAGING FINDINGS

Congenital and acquired anomalies of the basilar trunk are described. We provide a schematic and detailed representation of normal anatomical variants - mainly represented by the fenestrated basilar artery or the persistence of carotid-basilar anastomosis; course anomalies are also illustrated, with reference to neuro-vascular conflicts and dolichoectasia. Among congenital anomalies, this pictorial review also shows the variants of the basilar origin, such as in the case of basilar trunk arising from only one of the two vertebral arteries, and the calibre changes - which are represented by aneurysm and hypoplasia. The latter appears to be a risk factor for posterior circulation stroke, when associated with a bilateral posterior foetal variant.Among the acquired forms, this pictorial essay describes some clinical cases of dissections, non-congenital aneurysms, thrombosis and tumour with vascular encasing or compression of basilar artery.

CONCLUSION

CT angiography and MRI allow us to study the posterior intracranial circulation in detail, providing useful pre-treatment information. Therefore, knowledge of congenital or acquired anomalies of the basilar artery is essential for radiologists, neuroradiologists and neurosurgeons.