PMC7445531_01
(A and B) Axial non-contrast computed tomography and T2-weighted magnetic resonance (MR) images show a dilated and markedly tortuous basilar artery (asterisk) of 5.9 mm diameter traversing and distorting the left surface of the pons. (C) Axial diffusion-weighted MR image obtained at the level of the pons shows no infarct.
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Admission non-contrasted computed tomography (CT) and magnetic resonance imaging (MRI) showed a markedly dilated and tortuous vessel, compressing the left dorsal pons (Figure 1A and B). Diffusion-weighted MRI revealed no infarct in the pons (Figure 1C).
Computed tomography angiogram shows the tortuous course of the both basilar artery (BA, arrowheads) and the right vertebral artery (VA, arrows). The dolichoectatic BA curves to the left side, then takes a sharp turn to the right, and continues as the tortuous dilated right VA.
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CT angiography confirmed that the basilar artery (BA) was dolichoectatic and curved to the left side, and the right vertebral artery (VA) was ectatic and tortuous (Figure 2).
High-resolution magnetic resonance (MR) images of 3D-constructive interference in steady-state show the neurovascular conflict. (A and B) Axial and sagittal MR images reveal that a remarkably enlarged basilar artery (BA, asterisk) stretches the left abducent nerve (arrowhead), causing superior displacement. (C and D) Axial MR image demonstrates that the dolichoectatic BA (asterisk) is adjacent to the left facial nerve (thin arrow) and compresses on the root exit zone of the left vestibulocochlear nerve complex (thick arrow); coronal MR image shows that the right eighth nerve (thick arrow) is visible, and the BA takes a sharp turn to the right, joining the right vertebral artery (double asterisks).
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High-resolution MRI with 3D-constructive interference in steady-state (3D-CISS) revealed that a dolichoectatic BA was clearly compressed the abducent nerve and the vestibulocochlear nerve complex on the left side (Figure 3).