Download PDF
CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2020; 9(03): 199-203
DOI: 10.1055/s-0039-3402536
Case Report

Target Sign of Third Ventricle in Basilar Dolichoectasia with Multiple Clinical Presentations: A Case Report

Akshay S. Patil
1   Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
,
Sandeep Iratwar
1   Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
,
Chetan Rathod
1   Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
,
Paresh Korde
1   Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Basilar dolichoectasia (BDE) is an uncommon anatomical variant usually detected incidentally or during stroke evaluation. BDE can occasionally become symptomatic and may present with stroke (infarct or hemorrhage), raised intracranial pressure due to obstructive hydrocephalus, or with cranial nerve palsies. We present a unique case of BDE presenting with obstructive hydrocephalus, stroke, and cranial nerve palsy in single patient and propose a radiological sign (target sign of third ventricle), which could aid in imaging diagnosis and further management.

Keywords

basilar dolichoectasia - hydrocephalus - subarachnoid hemorrhage


Publication History

Article published online:
02 March 2020

© 2020. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Passero SG, Rossi S, Giannini F. Natural history of vertebrobasilar dolichoectasia. Neurology 2008; 70 (01) 66-72
    CrossrefPubMedGoogle Scholar
  • 2 Mangrum WI, Huston III J, Link MJ. et al. Enlarging vertebrobasilar nonsaccular intracranial aneurysms: frequency, predictors, and clinical outcome of growth. J Neurosurg 2005; 102 (01) 72-79
    CrossrefPubMedGoogle Scholar
  • 3 Nakamura Y, Hirayama T, Ikeda K. Clinicoradiologic features of vertebrobasilar dolichoectasia in stroke patients. J Stroke Cerebrovasc Dis 2012; 21 (01) 5-10
    CrossrefPubMedGoogle Scholar
  • 4 Yu YL, Moseley IF, Pullicino P, McDonald WI. The clinical picture of ectasia of the intracerebral arteries. J Neurol Neurosurg Psychiatry 1982; 45 (01) 29-36
    CrossrefPubMedGoogle Scholar
  • 5 Kumral E, Kisabay A, Ataç C, Kaya C, Calli C. The mechanism of ischemic stroke in patients with dolichoectatic basilar artery. Eur J Neurol 2005; 12 (06) 437-444
    CrossrefPubMedGoogle Scholar
  • 6 Steel JG, Thomas HA, Strollo PJ. Fusiform basilar aneurysm as a cause of embolic stroke. Stroke 1982; 13 (05) 712-716
    CrossrefPubMedGoogle Scholar
  • 7 Ubogu EE, Zaidat OO. Vertebrobasilar dolichoectasia diagnosed by magnetic resonance angiography and risk of stroke and death: a cohort study. J Neurol Neurosurg Psychiatry 2004; 75 (01) 22-26
    CrossrefPubMedGoogle Scholar
  • 8 Echiverri HC, Rubino FA, Gupta SR, Gujrati M. Fusiform aneurysm of the vertebrobasilar arterial system. Stroke 1989; 20 (12) 1741-1747
    CrossrefPubMedGoogle Scholar
  • 9 Aiba T, Nakazawa T. Non-communicating hydrocephalus due to megadolichobasilar artery–case report. Neurol Med Chir (Tokyo) 1995; 35 (02) 104-106
    CrossrefPubMedGoogle Scholar
  • 10 Branco G, Goulão A, Ferro JM. MRI in aqueduct compression and obstructive hydrocephalus due to an ecstatic basilar artery. Neuroradiology 1993; 35 (06) 447-448
    CrossrefPubMedGoogle Scholar
  • 11 Ekbom K, Greitz T, Kugelberg E. Hydrocephalus due to ectasia of the basilar artery. J Neurol Sci 1969; 8 (03) 465-477
    CrossrefPubMedGoogle Scholar
  • 12 Marinescu M, Remy A, Dufour H, Derome P, Cambon H. [A peculiar mechanism of hydrocephalus: the “water-hammering” effect]. Neurochirurgie 1998; 44 (02) 117-120
    PubMedGoogle Scholar
  • 13 Ricci G, Lenzi J, Esposito V. Hydrocephalus caused by dolichoectatic basilar artery. Case report. J Neurosurg Sci 2000; 44 (03) 155-158
    PubMedGoogle Scholar
  • 14 Siddiqui A, Chew NS, Miszkiel K. Vertebrobasilar dolichoectasia: a rare cause of obstructive hydrocephalus: case report. Br J Radiol 2008; 81 (964) e123-e126
    CrossrefPubMedGoogle Scholar
  • 15 Smoker WRK, Corbett JJ, Gentry LR, Keyes WD, Price MJ, McKusker S. High-resolution computed tomography of the basilar artery: 2. Vertebrobasilar dolichoectasia: clinical-pathologic correlation and review. Am J Neuroradiol 1986; 7 (01) 61-72
    PubMedGoogle Scholar
  • 16 Breig A, Ekbom K, Greitz T, Kugelberg E. Hydrocephalus due to elongated basilar artery. A new clinicoradiological syndrome. Lancet 1967; 1: 874-875
    CrossrefPubMedGoogle Scholar
  • 17 Rozario RA, Levine HL, Scott RM. Obstructive hydrocephalus secondary to an ectatic basilar artery surgical Neurology. 1978; 9 (01) 31-34
    PubMedGoogle Scholar
  • 18 Healy JF, Well MV. HYPERLINK “https://www.ncbi.nlm.nih.gov/pubmed/?term=Rosenkrantz%20H%5BAuthor%5D&cauthor=true&cauthor_uid=6976881”. Rosenkrantz H. Computed tomography demonstration of enlarged ectatic basilar artery associated with obstruction of anterior third ventricle compression Radiology. 1981; 5 (04) 239-245
    PubMedGoogle Scholar
  • 19 Branco G, Ginlao A, Ferro JM. MRI in aqueduct compression and obstructive HCP due to ectatic basilar artery. Neuroradiology 1993; 35 (06) 447-448
    CrossrefPubMedGoogle Scholar
  • 20 Weber MA, Steiner T, Fiebach J. Ungewöhnliche Ursache einer akuten Bewusstseinseintrübung. Radiologe 2002; 42: 833-836
    CrossrefPubMedGoogle Scholar
  • 21 Thiex R, Mull M. Basilar megadolicho trunk causing obstructive hydrocephalus at the foramina of Monro. Surgical Neurology 2006; 65 (02) 199-201
    CrossrefPubMedGoogle Scholar
  • 22 Kansal R, Mahore A, Dange N, Kukreja S. Dolichoectasia of vertebrobasilar arteries as a cause of hydrocephalus. Journal of Neurosciences in Rural Practice 2011; 2 (01) 62-64
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Seshadri R, Sadashiva N, Shukla D, Saini J, Pandey P. Vertebrobasilar dolichoectasia presenting as symptomatic obstructive hydrocephalus: A case report with review of literature. IJNS 2012; 1 (02) 165-168
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Çelik Ö, Berkman ZM, Orakdöğen M, Ayan E, Somay H, Düzkalir HA. Obstructive hydrocephalus due to vertebrobasilar dolichoectasia: diagnostic and therapeutic considerations. J Neurol Surg A Cent Eur Neurosurg 2013; 74 (Suppl. 01) e4-e8
    PubMedGoogle Scholar
  • 25 Zisimopoulou V, Ntouniadaki A, Aggelidakis P, Siatouni A, Gatzonis S, Tavernarakis A. Vertebrobasilar Dolichoectasia Induced Hydrocephalus: the Water-Hammer Effect. Clin Pract 2015; 5 (02) 749
    CrossrefPubMedGoogle Scholar
  • 26 Ebrahimzadeh K, Bakhtevari MH, Shafizad M, Rezaei O. Hydrocephalus as a rare complication of vertebrobasilar dolichoectasia: a case report and review of literature. Surgical Neurology International 2017; 8: 256
    CrossrefPubMedGoogle Scholar