Ruptured vertebral artery dissecting aneurysm associated with parent artery occlusion.
A 63-year-old hypertensive man presented with vertebral artery (VA) dissection manifesting as subarachnoid hemorrhage located mainly in the posterior fossa. Left vertebral angiography on the day of hemorrhage showed complete occlusion of the left VA. Right vertebral angiography showed retrograde filling of the distal portion of the left VA and the left posterior inferior cerebellar artery, and a "double lumen"-like finding in the left VA. He was managed conservatively. Follow-up angiography on Day 29 showed spontaneous recanalization of the occlusive lesion and an almost normal arterial configuration. T2-weighted magnetic resonance (MR) imaging on Day 45 revealed multiple infarctions in the brainstem. T1-weighted MR imaging showed a high intensity area, suggestive of intramural hematoma, in the left VA. He was transferred to another hospital in a persistent vegetative state.
Sakai
Kyoji
K
Department of Neurosurgery, Himeji Central Hospital, Himeji, Hyogo, Japan.
Kameda
Masahiro
M
Tanimoto
Takaho
T
Terasaka
Kaoru
K
Sugatani
Hiroshi
H
Higashi
Toru
T
D017542:Aneurysm, Ruptured / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D002533:Cerebral Angiography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology