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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:1194-1196, August 2004
© 2004 American Society of Neuroradiology

Case Report
BRAIN

Persistent Nonfused Segments of the Basilar Artery: Longitudinal versus Axial Nonfusion

Brian L. Hoh^a,b, James D. Rabinov^a, Johnny C. Pryor^a, Joshua A. Hirsch^a, Elizabeth C. Dooling^c and Christopher S. Ogilvy^b

^a Endovascular Neurosurgery and Interventional Neuroradiology Service, Departments of Neurosurgery and Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
^b Cerebrovascular Surgery Service, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
^c Pediatric Neurology Service, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA

Address correspondence to Brian L. Hoh, MD, Endovascular Neurosurgery and Interventional Neuroradiology, Massachusetts General Hospital, Gray 289, 55 Fruit Street, Boston, MA 02114

Summary: Embryologic development of the basilar artery occurs along two axis systems: longitudinal fusion and axial fusion. Longitudinal fusion consists of midline fusion of paired ventral arteries and reflects the simplified pattern of arterial anatomy found in the spinal cord. Axial fusion consists of fusion of the distal basilar artery, which arises from the caudal division of the internal carotid artery, to the midbasilar agenesis to the posterior inferior cerebellar artery termination of the vertebral arteries. Persistent longitudinal nonfusion (or complete duplication) of the basilar artery is very rare, and persistent axial nonfusion is even rarer. We report one case of persistent longitudinal nonfusion of the basilar artery in a 3-year-old boy and a case of persistent axial nonfusion of the basilar artery in a 43-year-old man.

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