Fusiform Basilar Artery Aneurysm Associated with Pontine Lacunar Infarctions

Abstract

A 47-year-old woman with hypertension and chronic
kidney disease (CKD) was admitted for clinical syndrome of hypertensive urgency. On initial examination,
she was found to have right-sided weakness and gait
ataxia, while rest of the neurological examination was
within normal limits. The patient reported that these
symptoms gradually started 6 month ago, for which she
never seek medical attention. Magnetic resonance
angiography (MRA) showed aneurysmal distention of
the basilar artery. (Fig. A) The artery measured 58 mm
in length and 16 mm in diameter, pressing on the right
pons. (Fig. B) Lacunar infarcts were also revealed in left
pons, most likely caused by perforator occlusion within
the aneurysm. Antiplatelet, antihypertensive, and lipidlowering therapy was initiated, and patient was discharged with close follow-up by neurology and neurointervention divisions.