Giant fusiform aneurysm of the basilar artery. Clinico-pathological report of 3 cases.

From 9000 autopsies, three giant fusiform aneurysms of the basilar artery were found in middle-aged men with arterial hypertension, atherosclerosis, symptoms of encephalic circulatory disturbances, transient then permanent cranial nerves palsy. Neuroradiological investigations suggested a basilar dolichomegartery in one case. Anatomically, these unruptured giant aneurysms (respectively: 2, 2.5 and 4.5 cm largest transversal diameter) compressed the brainstem; a recent softening destroyed the midpons in one case, and both cerebral peduncles in another. A review of the literature underlined the paucity of similar cases, and the difficulty of differential diagnosis of giant basilar aneurysms detected only by neuroradiological investigations without anatomical verifications.