[Subarachnoid hemorrhage secondary to dissecting aneurysms of the vertebral artery. Description of 2 cases and review of the literature].
OBJECTIVES AND INTRODUCTION: The pathogenesis and natural history of intracranial vertebral artery dissection remain uncertain up to now due in part to its relative rarity. In this article we review the state of the art of this process and remark the good outcome obtained with embolization using Guglielmi detachable coiling (GDC).


METHODS
Two cases with subarachnoid hemorrhage secondary to rupture of a vertebral dissection aneurysms are described. The first patient initially suffered brain stem infarction, followed by a subarachnoid hemorrhage a year later. The second patient who had a severe subarachnoid hemorrhage with two early rebleedings was successfully treated with embolization using GDC.


CONCLUSIONS
Subarachnoid hemorrhage due to rupture of vertebral dissecting aneurysm is a relatively unknown disease with some important aspects that should be known. The high incidence of early rebleeding (up to 60%), makes early diagnosis and treatment important goals. Classically the preferred treatment has been proximal vertebral artery occlusion. However, the recent introduction of embolization with GDC has made possible the occlusion of the dissection with very good final outcome.
Gómez
P A
PA
Servicio de Neurocirugía, Hospital 12 de Octubre, Madrid.
Campollo
J
J
Lobato
R D
RD
Lagares
A
A
Alén
J F
JF
D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation; D017809:Fatal Outcome; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D006973:Hypertension / Q000150:complications; D015994:Incidence; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D020767:Intracranial Thrombosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D012008:Recurrence; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D017287:Ventriculoperitoneal Shunt; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D014715:Vertebrobasilar Insufficiency / Q000209:etiology / Q000628:therapy
Hemorragia subaracnoidea secundaria a aneurismas disecantes de la arteria vertebral. Descripción de 2 casos y revisión de la literatura.