A case of vertebrobasilar dolichoectasia with acute brainstem compression and obstructive hydrocephalus entrapped between dissecting aneurysm and cerebellar infarction

Dolichoectatic aneurysm with cerebellar infarction

Abstract

Vertebrobasilar dolichoectasia (VBD) is relatively rare, and it can compress the brainstem and surrounding brain cistern due to its volume. It is frequently associated with arterial dissection, obstructive hydrocephalus, and infarction in the brainstem or cerebellum. We present a case of a 57-year-old man with a dissection localized to the basilar artery. However, the patient developed an infarction to the right posterior inferior cerebellar artery region, acute brainstem compression, and obstructive hydrocephalus caused by entrapment between the dissecting aneurysm and cerebellar infarction. Posterior fossa decompression and extraventricular drainage were performed immediately and alleviated his condition.

We suggest that such treatments may be needed at early stages, and we also review existing cases in the literature.