The clinical picture of a giant elongated basilar artery

: Lack of volition and immobilizing dizziness were the cardinal presenting symptoms of a 67-year-old man. On account of nonspecific inflammatory signs and weight loss of 18 kg, broad diagnostic tests were undertaken to exclude inflammatory or malignant disease. All were negative, but discrete neurological deficits pointed to cranial nerve or cerebral lesions which had brought about dizziness and dysphagia with vomiting and recurrent aspirations. The cause was found to be a giant aneurysmic dilation and lengthening of the basilar artery. Anticoagulant treatment may be used to reduce the risk of embolism, but complications caused by pressure on cerebral structures or by rupture cannot be avoided.