Complex Basilar Artery Aneurysms, severe stenosis basilar and PCA

Findings:

Axial noncontrast CT images demonstrate a dilated ventricular system with a small amount of intraventricular hemorrhage. Extensive vascular calcifications are present. Source images from CTA demonstrate two large lobulated aneurysmal projections of the basilar artery. The volume rendered images also demonstrate a severe stenosis of the basilar artery just proximal to the aneurysm and additional significant stenosis of the left P1 segment.

Differential diagnosis:

None other than aneurysm really applies. Prepontine extraaxial soft tissue density masses may also be seen with meningioma, schwannoma, chordoma, and metastases.

Discussion:

Discussion of aneurysms and associated complications is found on several other cases on this site including these:

            -ACA aneurysm
            -delayed L MCA aneurysm rupture
            -L ICA aneurysm, initial neg angio
            -L PCOM w active extrav
            -SDH with PCOM aneurysm
            -giant petrous-cavernous aneurysm
            -Basilar aneurysm with fenestration
            -Basilar aneurysm- coiled
            -pericallosal aneurysm
            -mycotic aneurysm
            -posttraumatic ACA pseudoaneurysm
            -internal maxillary pseudoaneurysm
            -dissecting VB aneurysm

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