Ectasia of the basilar artery: the breadth of the clinical spectrum and the diagnostic value of computed tomography.

Five angiographically confirmed cases of ectasia of the basilar artery are described. Three patients presented with the classical combination of lower cranial nerve, bulbar, cerebellar and long tract signs and dementia, one as obstructive hydrocephalus with papilloedema, and the fifth with symptoms of chiasmal compression. All were above middle age and hypertensive. CT scanning demonstrated a partially calcified, tubular, enhancing prepontine and suprasellar mass in every case. Ventricular enlargement and cerebral parenchymal abnormalities were also present. These appearances are sufficiently characteristic to make invasive radiological investigation unnecessary.