Anterior Cerebral Artery and Middle Cerebral Artery Stroke in the Setting of Multiple Fusiform Aneurysms and Vertebrobasilar Dolichoectasia

We present a case of stroke in the setting of multiple fusiform aneurysms. This case is unique in several ways and highlights the risks, concerns, and treatment options of this lesser-known vascular disease. Fusiform aneurysms are an uncommon subtype of intracranial aneurysms compared to the traditional saccular type. Rarer is the prevalence of multiple fusiform aneurysms in one patient and in the anterior distribution. This case involves a 51-year-old man presenting with stroke-type symptoms and a moderate National Institutes of Health Stroke Scale score. Extensive radiographic testing demonstrated multifocal areas of restricted diffusion along the anterior cerebral and posterior middle cerebral artery distribution. Additionally, multiple fusiform aneurysms in the middle cerebral and anterior cerebral arteries were found, as well as a dolichoectasia in the vertebral basilar artery. This case will further elucidate the definition, diagnostic approach, and treatment modalities of fusiform aneurysms.