Dramatical deformation of basilar artery dolichoectasia related to short term recurrent stroke

A 45-year-old man presented with an acute pontine infarction with dolichoectasia of the basilar artery. Four days after initiation of antithrombotic therapy, the occurrence of symptomatic subarachnoid hemorrhage was confirmed by brain computed tomography (MRI), with a remarkable shrinkage of dolichoectasia of the basilar artery. Despite the discontinuation of antithrombotic therapy, subsequent multiple ruptures occurred with re-expanded DBA and the patient died of respiratory insufficiency. Since DBA has an anatomical structural abnormality in a vessel wall, a shape of vessel could dramatically be changed. Because a transformation of DBA diameter could occur in the course of ischemic and hemorrhagic stroke, we need to pay attention to change of DBA diameter.