Vertebrobasilar Dolichoectasia as a Rare Cause of Recurrent Episodes of Vertigo: A Case Report and Literature Review

Abstract

Vertebrobasilar dolichoectasia (VBD) is a rare form of arteriopathy characterized by elongation, widening and tortuosity of the artery in the posterior circulation of the brain. Usual presenting symptoms include ischemic stroke, hemorrhagic events and compressive features. Although a very commonly encountered neurologic symptom, vertigo is not an usual primary manifestation of VBD. We are reporting a case of a 50-year-old hypertensive lady who presented with recurrent vertigo. Neurological examination was significant for gait abnormality and left sided weakness. MRI of brain with MRA showed dilated and tortuous vertebral-basilar arteries. We managed the patient conservatively with strong focus on hypertension management and antiplatelet medications. This case is an example of why it is important to consider vascular pathology in cases with recurrent vertigo, especially in the presence of common cerebrovascular risk factors like hypertension. It is possible to reduce the incidence of future cerebrovascular events with early diagnosis and prompt risk factor management.

J Dhaka Med Coll. 2025; 34(2) : 140-143