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A unique finding of the basilar artery

  • Anatomic Variations
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Abstract

Variants of the posterior intracranial circulation are important for surgeon, interventionalists and radiologists. Herein, a unique configuration of the basilar artery is reported. A 54-year-old man with a history of COPD, hypothyroidism, smoking, and hyperlipidemia presented to an outside institution with nausea, confusion, altered mental status, and ataxia. The patient was evaluated for stroke. Imaging revealed rotation of the basilar apex of 180 degrees, fetal configuration of the posterior communicating artery, right posterior cerebral artery filling from the left vertebral artery, and duplication of the left and right superior cerebellar arteries. The patient continued to deteriorate neurologically and MRI revealed multifocal and symmetric signal abnormalities in the brain stem, thalami, basal ganglia, and hippocampi. The differential diagnosis included acute disseminated myeloencephalitis. Despite plasma exchange and steroid therapy, the patient died a few days later. This case report demonstrates a rare variation of the basilar apex.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada

    Raja Gnanadev, Marios Loukas & R. Shane Tubbs

  2. Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA

    Joe Iwanaga & R. Shane Tubbs

  3. Neuroscience Institute, Geisinger Medical Center, Danville, PA, USA

    Christoph J. Griessenauer

  4. Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA

    R. Shane Tubbs

  5. Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA

    R. Shane Tubbs

Authors
  1. Raja Gnanadev
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  2. Joe Iwanaga
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  3. Marios Loukas
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  4. R. Shane Tubbs
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  5. Christoph J. Griessenauer
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Contributions

RG: data collection, data analysis, and manuscript writing. JI: data analysis, and manuscript writing. ML: data analysis and manuscript editing. RST: protocol/project development and manuscript editing. CJG: protocol/project development, data collection, and manuscript editing.

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Correspondence to Joe Iwanaga.

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Gnanadev, R., Iwanaga, J., Loukas, M. et al. A unique finding of the basilar artery. Surg Radiol Anat 43, 301–303 (2021). https://doi.org/10.1007/s00276-020-02607-3

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  • DOI: https://doi.org/10.1007/s00276-020-02607-3

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