Multiple intracranial vessel fenestrations: A report of two cases from a tertiary care center

Intracranial vascular fenestrations are unique anatomical anomalies, consequential to developmental perturbations in vessel embryology. The importance of identification rests on its frequent association with disturbed cerebral flow dynamics and intracranial pathologies. Herein, we report two cases from the same institute of such an association. One presented with an isolated intraventricular hemorrhage, found to have basilar artery fenestrations, whereas the other presented with subarachnoid hemorrhage, with fenestrations involving both the anterior and posterior circulations. Neither of the two patients had any evidence of aneurysms, arteriovenous malformations, or dissections and were managed conservatively. Being acquainted with the anatomy and pathophysiology of these vascular aberrations are paramount in achieving optimal patient outcomes in certain vascular catastrophes.