title: Traction-induced rupture of an extracranial vertebral artery aneurysm associated with neurofibromatosis. A case report.
abstract: METHODS
  This report describes presumed traction-induced rupture of a vertebral artery aneurysm in a patient with neurofibromatosis Type I.
  
  
  OBJECTIVE
  To draw attention to the need for preoperative arteriography in the surgical management of severe cervical kyphosis in neurofibromatosis.
  
  
  BACKGROUND
  Aneurysmal dilatation is a rare but well-documented manifestation of neurofibromatosis. The complication of rupture of a vertebral artery lesion has not been described previously.
  
  
  METHODS
  The clinical features of the reported complication in a 56-year-old woman are detailed.
  
  
  RESULTS
  A successful outcome was achieved by embolization and later anterior and posterior spinal fusions.
  
  
  CONCLUSIONS
  Vertebral arteriography should be part of the preoperative assessment of neurofibromatotic cervical kyphosis. Skull traction may produce aneurysmal rupture.
authors.affiliation: Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Horsley
authors.forename: T K
authors.initials: TK
authors.lastname: Taylor
authors.forename: W A
authors.initials: WA
authors.lastname: Sorby
mesh_terms: D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D000792:Angiography; D002574:Cervical Vertebrae / Q000098:blood supply / Q000473:pathology; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009456:Neurofibromatosis 1 / Q000150:complications*; D014143:Traction / Q000009:adverse effects*; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology