PMC4744067_01
Extracranial vertebral artery fenestration in a 35-year-old hypertensive lady who presented with a right putamen hemorrhage. 1A: Acute right putamen hemorrhage in CT scan. 1B: Detection of both widely placed fenestrated segments of VA (arrows) in selective left VA injection (AP view). Length/width of the right limb is 58.7 mm/3.1 mm and the left limb is 62.3 mm/2.9 mm. VA diameters distal to fenestration are 4.0 mm and proximal is 4.3 mm. 1C: Bony landmark of the C1 vertebra (long arrow) in lateral view.
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FIG1
A CT scan showed a 4.8 x 1.9 cm right putaminal bleed (Figure 1A). Extracranial VA fenestration at the level of C1 and C2 was demonstrated on left VA injection (Figure 1A-1B).
PMC4744067_02
Intracranial vertebral artery fenestration in a 54-year-old man with a right thalamic bleed . 2A: Plain CT scan shows a right thalamic bleed. 2B: VA fenestration involving both intracranial (arrowhead) and extracranial segments in lateral view on selective left VA angiography, the long arrow indicating the bony impression of the posterior arch of the C1 vertebra. 2C: Oblique view of VA fenestration (arrowhead). Length/width of the right limb is 20.7 mm/2.2 mm and of the left limb is 33.5 mm/3.1 mm. VA diameters distal to fenestration is 3.4 mm and proximal measurement is 3.9 mm.
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FIG2
A plain CT scan detected a 2.8 x 2.4 cm acute bleed in the right thalamus and posterior limb of the internal capsule (Figure 2A). On digital subtraction angiogram (DSA), VA fenestration was demonstrated in the selective left vertebral angiography (Figure 2B-2C).