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Basilar artery (BA) fenestration and its occlusion are relatively rare conditions. Mechanical thrombectomy for fenestrated BA occlusion has a high risk of complications. One limb occlusion or partial occlusion of fenestration mimics arterial stenosis or dissection. We present the case of a 75-year-old woman who presented with slight dysarthria, which subsequently worsened. Magnetic resonance imaging, magnetic resonance angiography, and basi-parallel anatomical scanning (BPAS) revealed BA fenestration and occlusion of the larger limb of the fenestrated BA, for which we performed thrombectomy with aspiration and achieved Thrombolysis in Cerebral Infarction Grade 3 flow restoration without procedure-related complications. If BA occlusion occurs at a site where a thrombus does not normally occur, confirming the anatomy of the BA before thrombectomy is desirable. As we obtained information on BA fenestration and occluded limb diameter using preoperative BPAS, we were able to safely achieve effective recanalization by guiding a relatively large-diameter aspiration catheter to the thrombus coaxially with a micro-guidewire and microcatheter.

Intracranial solitary fibrous tumor (SFT) / Hemangiopericytoma (HPC) is a rare mesenchymal tumor. The occurrence in the orbit is quite rare, with only 2/244 cases in the Japanese population of primary tumors in the orbit. Herein, we report the case of a 54-yearold woman who presented with right visual disturbance. The vision had worsened and was lost after a year. Three years later, magnetic resonance image (MRI) revealed a right intraorbital tumor, and 16 years later, swelling of the right eyelid and exophthalmos appeared. Computed Tomography (CT)scan revealed a well-defined homogeneous mass in the orbito-cranial communicating region, and MRI revealed a 30 mm mass lesion compressing the right optic nerve, presenting with low signal intensity on T1-weighted image (T1WI) and T2-weighted image with heterogeneous contrast effects. Also, dynamic contrast-enhanced T1WI revealed slow signal enhance effect. The lesion was surgically resected via right frontotemporal craniotomy. Histopathological examination of the lesion revealed SFT. Immunopathologically, the tumor was negative for S-100, glial fibrillary acidic protein, epithelial membrane antigen, synaptophysin, while was positive for cluster of differentiation 34, B cell/chronic lymphocytic leukemia lymphoma 2. Moreover, signal transducer and activator of transcription 6 was positive in intranuclear, and Ki-67 was negative in most of the cells. The postoperative course is uneventful without recurrence after 4 years. SFT of the orbit should be considered as a differential diagnosis although it is extremely rare disease. It is similar to meningioma and schwannoma and we should take Dynamic-Contrast-Enhanced MRI for preoperative diagnosis. Careful postoperative follow-up is needed because some cases report recurrence and malignant transformation. [ABSTRACT FROM AUTHOR]