TITLE:
Large Basilar Trunk Aneurysm Discovered Incidentally in a Patient with Ischaemic Stroke: Case Report
AUTHORS:
Wendlassida Martin Nacanabo, Yannick Laurent Tchenadoyo Bayala, Abdoul Nassir Porgo, Emilie Agathe Carama, Bademain Jean Fabrice Ido, Taryètba André Arthur Seghda, Wendlassida Léa Francoise Sawadogo, Sidy Mahamoud Guebre, Abdoul-Aziz, Christian Napon, André K. Samadoulougou
KEYWORDS:
Aneurysm, Ischemic Stroke, Thrombolysis
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.11,
November
30,
2023
ABSTRACT: Summary: Many anomalies can be observed in the basilar trunk, such as aneurysms.
Basilar trunk aneurysms are rare with a low reported prevalence. In this study,
we describe a case of ischaemic stroke revealed by a basilar trunk aneurysm associated
with venous thromboembolic disease. The patient was 60 years old and had no
specific pathological history. She was seen for a sudden onset of right
hemiplegia associated with dysarthria that had been present for 12 hours. The
physical examination revealed a pyramidal syndrome and an altered general
condition. An emergency cerebral computed tomography (CT) scan showed evidence
of a cerebrovascular accident associated with a saccular aneurysm. We adopted
the diagnosis of a deep left sylvian stroke associated with a superficial right
sylvian stroke in the setting of an incidentally discovered basilar trunk
aneurysm. On the 9ème day of hospitalisation, the patient
experienced sudden onset of respiratory distress in conjunction with a warm,
painful swelling of the right leg. TTE revealed signs of pulmonary embolism,
with thrombi in the inferior vena cava and right atrium. Pulmonary embolism was
highly probable, with a modified Geneva score of 15. We adopted the diagnosis
of DVA complicated by pulmonary embolism in the setting of a basilar trunk
aneurysm. The patient was transferred to the cardiology department, where she
received oxygen therapy and thrombolysis with streptokinase. The immediate
outcome 6 hours later was the sudden death of the patient due to the onset of
cardiogenic shock.