Department of Pathology, University of Oklahoma Health Sciences Center

NeuroTest Question #1 Next question

Answer: C (dolichoectasia) Level of difficulty: 1 NeuroTest NeuroLearn NeuroHelp

Discussion: 

• Location: This is a view taken from the base of the brain and the structure being labeled is the basilar artery. 
• Dolichoectasia: (dolicho- means long)The artery is dilated, with a rigid appearance and have yellowish discoloration. These changes are diagnostic for atherosclerosis and the vessel is also dilated. It is also elongated, widened, and tortuous. This features are that of dolichoectasia and are common in patients with advanced atherosclerosis. The most common sites are the basilar artery and the changes can extend to the vertebral artery. The other common site is the supraclinoid segment of the internal carotid artery with possible extension into the middle cerebral artery. They have also been described in young non-atheromatous patients and some of them are associated with  Ehler-Danlo's syndrome type IV, Marfan's syndrome, pseudoxanthoma elasticum, and a₁-antitrypsin deficiency.
• Schwannomas occur in this location (the cerebellar-pontine angle). The structure in question is a blood vessels and does not have the slightest suggestion of a tumor.
• Berry (sacular) aneurysms, as reflected by its name, appear as small berry-like structures attached to the blood vessels. They are usually thin-walled. Berry aneurysms are most commonly found at or very close to the point of bifurcation of intracranial arteries with the circle of Willis as the most common site.
• Charcot-Bouchard aneurysms, also known as miliary aneurysms or microaneurysms, occur in small arteries around 100-300 mm in diameter. They are found most commonly at the putamen, globus pallidus, and thalamus. They can also be seen in other areas such as the caudate, internal capsule, centrum semiovale, and cortical gray matter.   In most cases, they are associated with hypertension.

Comment: KarMing-Fung@ouhsc.edu