Symptomatic obstructive hydrocephalus due to cerebrospinal fluid pathway obstruction from vertebrobasilar dolichoectasia
Keywords:
Digital Subtraction Angiography, Obstructive Hydrocephalus, Vertebrobasilar DolicoectasiaAbstract
Vertebrobasilar Dolichoectasia (VBD) is a rare vascular anomaly in which the vertebral/basilar artery is elongated, swollen, and tortuous. Symptoms can be ischemic or obstructive hydrocephalus although they are rarely found because it is usually asymptomatic. Therefore, it is necessary to establish a proper diagnosis to obtain appropriate management. A 62-year-old man had memory loss, imbalance walking, and urinary incontinence which then gradually decreased consciousness. Magnetic resonance imaging (MRI) revealed active hydrocephalus obstruction and suspicion of a fusiform type aneurysm in the basilar artery. Digital Subtraction Angiography (DSA) procedure was performed and the dolichoectasia of the basilar artery was obtained with non-communicant hydrocephalus which then improved after a Ventriculo-Peritoneal (VP) shunt was inserted. The information in this case report is essential for scholarly purposes and the participant gave written informed consent for publication.The gold standard imaging with DSA is needed to confirm the case of VBD. Information regarding the management of patients with VBD is scarce. Patients with manifestations of compression may undergo surgical evaluation with arterial repositioning or ventricular shunt placement. For patients with cerebrovascular complications, acute management should be based on the best care practices for patients with hemorrhagic or ischemic stroke.
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