Subarachnoid hemorrhage as a presentation of basilar artery dissection.
BACKGROUND
Subarachnoid hemorrhages caused by intracranial dissections are rare. The management of dissections in these cases not clear.


METHODS
Case report.


RESULTS
An 82-year-old woman presented with acute drowsiness and vomiting. CT scan demonstrated extensive subarachnoid hemorrhage and hydrocephalus that subsequently required placement of ventriculoperitoneal shunt. Angiography revealed extensive basilar artery dissection and no aneurysms. The dissection did not produce a critical stenosis and, taking into consideration that the patient had a previous occlusion of her distal left vertebral artery, it was decided to manage the patient conservatively. On a 3-month follow-up, the patient was free of recurrent events.


CONCLUSIONS
Basilar artery dissection can present with subarachnoid hemorrhage. No guidelines are available for management of basilar artery dissections and treatment should be tailored to the individual patient.
Zubkov
Alexander Y
AY
Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Sanghvi
Amit N
AN
Cloft
Harry J
HJ
Wijdicks
Eelco F M
EF
Rabinstein
Alejandro A
AA
D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed