0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Images in Neurology |

Thrombosis in a Giant Basilar Trunk Fusiform Aneurysm

Yuji Kato, MD, PhD; Hidetaka Takeda, MD, PhD; Tomohisa Dembo, MD, PhD; Ichiro Deguchi, MD; Takuya Fukuoka, MD; Norio Tanahashi, MD, PhD
Arch Neurol. 2011;68(7):944-945. doi:10.1001/archneurol.2011.134.
Text Size: A A A
Published online

Extract

Basilar trunk aneurysm (also called dolichoectasia) is a relatively rare pathologic condition, and little is known about its natural history and optimal management.1 We describe a 66-year-old woman who had been receiving antihypertensive treatment and who presented with sudden left facial palsy. Her neurological symptoms deteriorated rapidly in the ambulance on the way to the hospital. Upon admission, she was unconscious and had left facial palsy and severe right arm and leg paresis. Cranial computed tomography revealed a giant fusiform aneurysm of the basilar artery with a thrombus in the lumen (Figure, A). Brain magnetic resonance imaging (MRI) revealed slightly restricted diffusion in the left pons with deformation caused by an aneurysm (Figure, B). Magnetic resonance angiography showed indistinct flow of the basilar artery, probably due to turbulence and slow flow (Figure, C). We applied basiparallel anatomic scanning (BPAS)–MRI2 to evaluate the surface of the vertebrobasilar artery. The technique required 2-cm-thick, heavily T2-weighted coronal imaging parallel to the clivus, with grayscale reversal during postprocessing. The BPAS-MRI confirmed a giant fusiform aneurysm of the basilar artery (Figure, D). The patient was treated with intravenous sodium ozagrel (a thromboxane A2 synthase inhibitor) and glycerol solution under strict blood pressure control. However, she remained comatose and required endotracheal intubation to maintain breathing. She died of respiratory arrest on the day after admission.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
/>
First page PDF preview

Figures

Place holder to copy figure label and caption
Graphic Jump Location

Figure. Radiological images. A, Brain computed tomography shows a thrombus in a giant aneurysm of the basilar artery as a high-intensity lesion (arrows). B, Brain magnetic resonance imaging (MRI) shows slightly restricted diffusion in the left pons (arrows) with deformation caused by the aneurysm. C, A magnetic resonance angiogram shows indistinct flow in the basilar artery. D, Fusiform dilation of the basilar artery shows a mural thrombus (arrows) that was detected by basiparallel anatomic scanning–MRI (repetition time, 10 000 milliseconds; echo time, 548 milliseconds).

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();