Acute pontine infarction in a patient with 8-shaped basilar artery fenestration malformation: A case report

Introduction: Cerebrovascular fenestration malformation is a relatively rare vascular dysplasia, and an 8-shaped basilar artery fenestration malformation is even rarer. The characteristics of transcranial Doppler cerebral blood flow in cerebrovascular fenestration malformations have rarely been studied or reported. Patient concerns: A 58-year-old woman presented with hypertension, diabetes, with no history of smoking or drinking. The patient had no relevant family history. The patient experienced left limb weakness for 2 days, which gradually worsened. Diagnosis: Head and neck computed tomography angiography revealed an 8-shaped fenestration deformity of the lower segment of the basilar artery with multiple stenoses of the local vessels. Transcranial Doppler cerebral blood flow examination at a depth of 85 cm revealed an eddy current in the lower segment of the basilar artery. Interventions: Tirofiban was administered intravenously for 3 days and subsequently changed to oral clopidogrel antiplatelet treatment. Outcomes: The modified Rankin Scale score at 3 months after disease onset was 0, indicating that the patient recovered well after treatment. Conclusion: A basilar artery 8-shaped fenestration is extremely rare and has seldom been reported. Cerebral vascular fenestration can lead to an acute cerebral infarction and its pathogenesis may include local hemodynamic abnormalities and thrombosis. Eddy currents can be detected by transcranial Doppler cerebral blood flow examination.