EURORAD ESR

Case 15850

Vertebrobasilar dolichoectasia and Trigeminal neuralgia

Author(s)
Kiran M1, Eshwar Chandra N2, Srinadh Boppana3

Dr Kiran M1, Senior Resident, Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India; Email:kirandmk@gmail.com.
Dr Eshwar Chandra N2, Consultant, Department of Radiodiagnosis, Virinchi Hospital, Hyderabad, India.
Dr Srinadh Boppana3, Consultant, Department of Radiodiagnosis, Kamineni Hospital, LB Nagar, Hyderabad, India.
 
Patient
male, 55 year(s)
 
 
  • Figure 1
    MRI brain
     

    T2W coronal image showing flow voids of bilateral vertebral arteries (arrow heads) and basilar artery (arrow) crossing the midline.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    3D-CISS showing tortuous, dilated(6mm) basilar artery(arrow head) crossing midline by compressing left abducent nerve(long arrow), left trigeminal nerve(short arrow), right trigeminal nerve and reaching anterior...

     
    Area of Interest: Arteries / Aorta; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    3D CISS image to show the left vertebral artery (arrow head) compressing left facial and vestibulocochlear nerves (arrow).

     
    Area of Interest: Arteries / Aorta; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    3D CISS image showing basilar artery (arrow head) compressing the right occulomotor nerve (arrow) just before bifurcating into posterior cerebral arteries.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Dilatation;

    3D CISS image showing ectatic bilateral internal carotid arteries (arrows).

     
    Area of Interest: Arteries / Aorta; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Dilatation;
     
     
  • Figure 2
    Intraoperative image

    Operative picture to show the ectatic basilar artery (arrow) compressing the left trigeminal nerve (arrow head) which is thinned out.

     
    Area of Interest: Arteries / Aorta; Imaging Technique: Image manipulation / Reconstruction; Procedure: Intraoperative; Special Focus: Pathology;
     
     
T2W coronal image showing flow voids of bilateral vertebral arteries (arrow heads) and basilar artery (arrow) crossing the midline.
 
3D-CISS showing tortuous, dilated(6mm) basilar artery(arrow head) crossing midline by compressing left abducent nerve(long arrow), left trigeminal nerve(short arrow), right trigeminal nerve and reaching anterior aspect of right half of pons.
 
3D CISS image to show the left vertebral artery (arrow head) compressing left facial and vestibulocochlear nerves (arrow).
 
3D CISS image showing basilar artery (arrow head) compressing the right occulomotor nerve (arrow) just before bifurcating into posterior cerebral arteries.
 
3D CISS image showing ectatic bilateral internal carotid arteries (arrows).
 
Operative picture to show the ectatic basilar artery (arrow) compressing the left trigeminal nerve (arrow head) which is thinned out.
 
 
 
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