Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: vertebral basilar dolichoectasia

Forum: Neurology Forum
Topic: Stroke

Re: vertebral basilar dolichoectasia

Re: vertebral basilar dolichoectasia

Posted by CCf Neuro MD *!* on November 12, 1997 at 15:31:43:

In Reply to: vertebral basilar dolichoectasia posted by Beverly A. Mile on November 06, 1997 at 20:00:32:

: Diagnosis: Vertebral basilar dolichoectasia to the right of midline.
Aneurysm in brain stem artery? I have searched numerous medical books in library for any description re: above to no avail. Questions: What can
be done for this condition? Can it be surgically corrected? If aneurysm
becomes larger than 3/8", chance of rupture is great? What preventative measures can be taken to alleviate symtoms (dizziness, visual disturbances and lightheadedness)? I understand anticoagulants are used to prevent
a "bleeding" stroke which can occur due to ruptured aneurysm. I have
also asked MAYO Clinic who has NOTHING about this condition or any
brain stem problems in their entire database. I heard about you and
decided to query re: same. Please provide information re: above.
Merck Manual has a paragraph re: same -- that seems to be the ONLY
source for this information.

Thank you very much for your kind assistance.
Beverly Mile

=
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options for your specific medical condition.
Vertebrobasilar dolichoectasia is an anatomical term which refers to a basilar artery which is enlarged,
tortuous and partly displaced.
The normal basilar artery is centrally located and runs along the base of a part of the brainstem called the pons. It sends off fine branches into the substance of the brain which supply blood to vital structures in thr brainstem, blockage of one of these arteries would vause a stroke.
In the case of dolichoectasia the artery becomes enlarged and tortuous, bulges off to one side, and may form a localised dilatation or aneurysm, in a sense it becomes distorted and enlarged like varicose veins do in the legs, this analogy actually gives a good picture of what is actually happening.
Sympyoms may be caused by the artery pressing on nerve which pass through the same area.
Treatment of the condition is difficult because any attempt to interfere with the vessel runs a high risk of ripping off one of the tiny vessels which come off the basilar artery thereby causing a stroke.
If the distortion of the artery involves a segment which is very narrowed by hardening of the arteries anticoagulation may be advised as it reduces the chance of a clot forming and blocking off the artery completely. Anticoagulants have bleeding as a major side -effect if they are not closely monitored so they are not used to prevent a “bleeding stroke “.
The symptoms you mention could possibly be due to inadequate blood getting through this abnormal artery, in this case a combination of anticoagulation and blood pressure regulation is required.
If the blood pressure is too low it can exacerbate these symptoms so it needs to be very carefully managed under the close guidance of a neurologist with experience in this area.
If you wish to have further information on this question or see a stroke specialist who is experienced in dealing with this disorder and has access to the full range of diagnostic procedures and interventional therapies, an appointment can be made with the Cleveland clinic stroke section at (216) 444 5559.

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