What are the causes of basilar artery aneurysm and how to check it

What are the causes of basilar artery aneurysm? How to check?

What are the causes of basilar artery aneurysm?

1. Infection: Syphilis is the most prominent, often eroding the thoracic aorta. Bacteremia during sepsis and endocarditis allows the bacteria to reach the aorta through the bloodstream, and abscesses adjacent to the aorta spread directly, or secondary infection on the basis of atherosclerotic ulcers can form bacterial basilar artery aneurysms. Pathogenic bacteria are mainly streptococci, staphylococci and salmonella, which are less common.

Cystic medial necrosis: It is a relatively rare lesion with unknown etiology. The elastic fibers in the aorta media are broken and replaced by metachromatic acid mucopolysaccharides. It is mainly seen in ascending aortic aneurysms, more common in men. Genetic diseases such as Marfan syndrome, Turner syndrome, and Ehlers-Danlos syndrome can all cause cystic medial necrosis. It is easy to cause basilar artery aneurysms.

Atherosclerosis of the third artery is the most common cause. Atherosclerotic plaques erode the aortic wall, destroying the middle layer components and causing degeneration of elastic fibers. The wall thickens due to atherosclerosis, compressing the vasa vasorum, causing nutritional disorders, or rupturing the vasa vasorum and causing blood accumulation in the middle layer. It is more common in elderly men, with a male-female ratio of about 10:1. The main location is in the abdominal aorta, especially between the origin of the renal artery and the bifurcation of the iliac part.

How to check?

1X-ray computed tomography (CT) is also useful for diagnosis. The posteroanterior X-ray of basilar artery aneurysm shows that the ascending aorta is bulging, the aorta is widened, the esophageal aortic pressure mark is widened, the descending aorta has a significantly irregular outline, and multiple aneurysms are formed. The left anterior oblique X-ray of thoracic aortic aneurysm shows a wavy outline on the upper edge of the aortic arch, the esophagus is tortuous with the aorta, and the wavy edge represents the irregular dilatation and aneurysm of the adjacent aorta.

2 Aortography is also helpful for positioning diagnosis, but intraluminal thrombus may affect the assessment of the severity of the lesion. Therefore, aortography is still recommended for patients with unclear diagnosis, hypertensive patients with renal artery lesions when the aneurysm range is unclear, patients with suspected obstruction or tumor-like lesions, and those preparing for surgical treatment.