Case report: Diffuse intracranial dolichoectasia

Abstract

A male patient presented with faint, limb weakness and facial palsy, later he was confused and tried. The physician wearing an endotracheal tube and referred to chonburi hospital for the computed tomography (CT) of the brain and computed tomography angiography (CTA) of the brain.

CT and CTA of the brain reveals diffuse intracranial dolichoectasia and dissecting aneurysm of the vertebrobasilar system with partial thrombus and intramural hematoma. These dolichoectatic aneurysms are associated with chronic hypertension and smoking, corresponding to this patient ^(1,2). The dolichoectatic intracranial aneurysms are generally associated with a poor nature history with high rates of rupture, mass effect and ischemic stroke ^(3-6).

Notably, most prior reports of intracranial dolichoectasis have focused on involvement of single-vessel territories, most commonly the vertebrobasilar system ⁽¹⁾. The diffuse intracranial dolichoectasia with dissecting aneurysm of the vertebrobasilar system with partial thrombus and intramural hematoma are rare ⁽⁷⁾.

These dolichoectatic aneurysms are associated with a wide range of proposed, included chronic hypertension in this patient. The other cause, criteria for diagnosis of diffuse intracranial dolichoectasia and treatment guidelines will be discussed later in this paper.