[Dissecting aneurysm of the intracranial vertebral artery. An anatomo-clinical case].
A 64 year old patient with a cardiac prosthesis and receiving antivitamin K therapy presented with a right bulbar syndrome. Based on absence of meningeal signs and hemorrhage on CT scan heparin therapy was instituted. Fatal coma developed two and a half days later. Autopsy findings included a right lateral bulbar infarct and meningeal hemorrhage, predominant around a fusiform dilatation of the end of the right vertebral artery. Serial sections showed a large dissecting aneurysm between media and adventitia communicating with an intimal tear. Among intracranial dissecting aneurysms those of vertebrobasilar localization have the peculiarity of being subadventitial in some cases, with a subsequent enhanced risk of hemorrhagic complications. The use of anticoagulants appears contraindicated in these cases, even if their clinical expression is suggestive of an infarct. Their etiology is often unknown.
Michel
D
D
Service de Neurologie, Hôpital Bellevue, Saint-Etienne.
Pialat
J
J
Antoine
J C
JC
Laurent
B
B
Convers
P
P
D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D000925:Anticoagulants / Q000009:adverse effects; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D014711:Vertebral Artery / Q000000981:diagnostic imaging
D000925:Anticoagulants
Anévrysme disséquant de l'artère vertébrale intracrânienne. Un cas anatomo-clinique.