Noninvasive neuroimaging of basilar artery dolichoectasia in a patient with an isolated abducens nerve paresis.

Abstract

To describe the neuroimaging findings in a patient with an isolated abducens nerve palsy caused by a dolichoectatic basilar artery. Retrospective case report. A 65-year-old man presented with a 3-year history of gradually worsening horizontal double vision. He subsequently underwent magnetic resonance imaging, magnetic resonance angiography, and computed tomographic angiography. Neuroimaging revealed dolichoectasia of the basilar artery. The enlarged, tortuous vessel appeared to be compressing the subarachnoid portion of the nerve at its exit from the brainstem. Noninvasive neuroimaging studies are sufficient to establish a diagnosis of basilar artery dolichoectasia in patients with isolated cranial neuropathies.