Abstract
A case of dolichoectatic basilar artery with a mass effect to the brainstem structure was treated by reducing hemodynamic stress. In this case, angiograms showed the dolichoectatic basilar artery creating a turbulent flow in the vertebrobasilar junction. We therefore clipped the unilateral vertebral artery and performed posterior fossa decompression. The postoperative course was uneventful. Two years and 6 months after the operation, the patient died due to multiple brain stem infarction as a result of involvement of many important perforating arteries to the brainstem. Proximal ligation of the right vertebral artery resulted in reduction of turbulent flow but caused intraaneurysmal thrombosis.
Macroscopic examination showed distention and elongation of the vertebrobasilar artery like dolichoectasia, and microscopic examination revealed dissection of the vessels between the intima and medial smooth muscle. We therefore conclude that dolichoectasia of this case was caused by dissection of the basilar artery.
