Reflection on the progression and prognosis of vertebrobasilar dolichoectasia: A case report with vertebrobasilar ischemic attack, hemorrhage, and brain infarction

The diagnosis of vertebrobasilar dolichoectasia (VBD) has become easier since the development of non-invasive clinical imaging techniques. However, the early signs of VBD are not easily recognized. In order to improve the recognition and prevention of VBD, here we report a case of VBD with a history of diabetes and hypertension, which progressed from vertebrobasilar artery insufficiency into TIA gradually within a year, resulting in brain stem hemorrhage and cerebral infarction. We discussed the rapid progression and the possible reasons of the concurrent hemorrhage and brain infarction. We find that timely diagnosis with vascular imaging is necessary. The intervention of other early risk factors such as hypertension, diabetes, smoking, and heavy drinking is important to slow the progression. the application of antiplatelet therapy should be carefully considered.