GoodGirl
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What is the pathologic process that the arrow is pointing to: A. Acoustic schwannoma. B. Berry (sacular) aneurysm. C. Dolichoectasia. D. Charcot-Bouchard aneurysm. E. None of the above.
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| jean robert
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A??
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| docdoc9
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Dolichoectasia
After ruling out everything I was left only with that
Though I dont know what it means
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| docdoc9
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I dont know whether dolichoectasia is the answer
But I found this on the net
The term dolichoectasia means elongation and distention. In the vertebrobasilar system this term is appropriately used if the basilar artery courses lateral to the clivus or dorsum sellae or if the bifurcation of the basilar artery occurs above the plane of the suprasellar cisterns. Ectasia implies a basilar artery with a diameter greater than 4.5 mm. The pathogenesis is probably related to marked thinning of the internal elastic lamina and media, most likely a consequence of prolonged systemic arterial hypertension.
The clinical relevance of vertebrobasilar dolichoectasia (VBD) is related to the severity of the elongation and ectasia. Symptoms are related to direct cranial nerve compression, ischemic effects on the brain stem and cerebellar hemispheres as well as symptoms related to hydrocephalus. Direct cranial nerve compression can lead to isolated cranial nerve dysfunction, usually associated with a normal-sized basilar artery that is tortuous and elongated. Isolated cranial nerve dysfunction most commonly involves the VII cranial nerve (hemifacial spasm or paresis) and the V cranial nerve (trigeminal neuralgia). Multiple cranial nerve dysfunction is far more likely to occur if there is dilation (ectasia) associated with a tortuous and elongated basilar artery. Cranial nerves affected in descending order of frequency include: VII, V, III, VIII, and VI. Trigeminal neuralgia associated with hemifacial spasm is one commonly encountered combination.
ut this is what I found on net:
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| GoodGirl
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Answer: C (dolichoectasia)
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.
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| GoodGirl
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Thanks docdoc9 for additional explanation, I did not have a slightest idea about the meaning of this word and thought to post this q here, so we all could learn from it.
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| docdoc9
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Thanks goodgirl for the q.Even I did not know what dolichoectasia was
How i ruled out other options
Scwannoma........mostly in cerebellopontine angle and moreover the image here is dilaed tortuous and the cut part baloe shows a hollow so I ruled out it was a nerve
Berry aneurysm most common location is ant part of base of brain b/w ant cerebrat and ant communicating thats y I ruled it out
Charcot bouchard mainly from striate artery which is a branch of middle cerebral artery and moreover they r microaneurysms and they are on the surface of brain
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