fenestration of the vertebral artery

A case of

multiple Vertebrobasilar artery fenestration misdiagnosed as vertebral artery dissection. Multiple vascular abnormalities from the vertebrobasilar system in DSA. Extracranial DSA showing the vertebral artery fenestration at the V1 segment in the multiply direction (black arrows) (a-b). Intracranial DSA showing an ipsilateral large vertebral artery fenestration at the level of C1 and C2 (double white arrows), post-coil-embolization changes of giant aneurysm at the tip of basilar artery (small white arrow), and a small fenestration at the proximal basilar artery (long white arrow) (c-d). DSA = Digital subtraction angiography

A case of

multiple Vertebrobasilar artery fenestration misdiagnosed as vertebral artery dissection. The ‘double lumen’ sign and ‘intimal flap’ in CTA. CTA reconstruction images showing the ‘double lumen’ appearance at the V1 segment of the left vertebral artery (thick white arrows) (a-b). CTA axial images showing ‘double lumen’ sign and ‘intimal flap’ (thin white arrows) (c-d). CTA = Computed tomography angiography