Mass Effect in the Setting of Symptomatic Basilar Artery Dolichoectasia: A Case Series & Systematic Review of the Literature Regarding Reported Mass Effects & The Available Treatment Options to Date (P1.258)

Background: Dolichoectasia is a term used to describe elongated and dilated vessels that follow a tortuous and winding course with frequent loops and curves.Basilar dolichoectasia is rare and asymptomatic in ninety percent of patients, but when symptomatic, it can be divided into ischemic,hemorrhagic, and mass effect categories. Methods: We present a case series of patients presenting to the Cleveland Clinic in Florida between 2010 to 2015 with different sequela of mass effect, including trigeminal neuralgia, hemifacial spasm, hearing loss, and tinnitus in the setting of basilar ectasia.We also conduct a systematic review of the literature (through October 20, 2015) for studies reporting symptomatic mass effect due to basilar artery dolichoectasia, using pre-specified Medical Subjects Heading (MeSH) terms, Boolean logic, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)guidelines. Results: Abstract review identified 143 potential articles.82 articles were excluded due to lack of sufficient data.The remaining 61 studies were reported as follows: 14/61 (22[percnt]) obstructive hydrocephalus, 12/61 (19[percnt]) trigeminal neuralgia, 7/61 (11[percnt]) hemi-facial spasm, 5/61 (8[percnt]) hearing loss, 4/61 (6[percnt]) sixth cranial nerve palsy, 3/61 (4[percnt]) third cranial nerve palsy, 2/61 (3[percnt]) superior oblique muscle paresis, 2/61 (3[percnt]) visual field defects (compressing the visual pathways in the posterior suprasellar region), 2/61 (3[percnt]) tinnitus, 1/61 (1[percnt]) hypoglossal nerve palsy, 1/61 (1[percnt]) autonomic dysfunction, 1/61 (1[percnt]) bilateral vestibular loss, 1/61 (1[percnt]) chiasmal compression, 1/61 (1[percnt]) upgaze palsy, 1/61 (1[percnt]) basilar migraine, 1/61 (1[percnt]) trismus, 1/61 (1[percnt]) bilateral vestibular loss, 1/61 (1[percnt]) exertional headache, and 1/61 (1[percnt]) downbeat nystagmus. Conclusions: Basilar artery ectasia can cause various cranial neuropathies and symptoms with a wide variety of clinical presentations.Therefore, the condition ought to be considered as a differential diagnosis in situations where there is no clear explanatory etiology or when refractoriness to treatment occurs. Disclosure: Dr. Piran has nothing to disclose. Dr. Linn has nothing to disclose. Dr. Reyes has nothing to disclose. Dr. Mathew has nothing to disclose. Dr. Gleason has nothing to disclose. Dr. Khan has nothing to disclose.