Conservative treatment of ruptured vertebrobasilar dissecting aneurysm.
Ruptured vertebrobasilar dissecting aneurysm is usually treated surgically because rebleeding negatively affects outcome. However, the risk of rebleeding decreases markedly once several hours have passed from the initial bleeding. Moreover, surgery-related complications are not rare. We describe seven patients with ruptured vertebrobasilar dissecting aneurysm. To prevent rebleeding during the acute stage, we treated all seven patients conservatively with fentanyl instead of emergency surgery. During the follow-up period (mean 20 months), no patient suffered rebleeding. Conservative treatment with fentanyl administration may be a good option for management of ruptured vertebrobasilar dissecting aneurysm during the acute stage.
Hashimoto
Mizuki
M
Department of Neurosurgery, Hiratsuka Kyosai Hospital, Hiratsuka, Japan.
Johkura
Ken
K
Ichikawa
Teruo
T
Kojima
Akio
A
Nishimura
Satoshi
S
Shinonaga
Masamichi
M
D000759:Adjuvants, Anesthesia / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001488:Basilar Artery / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D001510:Bed Rest; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D016292:Procedural Sedation / Q000379:methods; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D002532:Intracranial Aneurysm / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D020767:Intracranial Thrombosis / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009529:Nicardipine / Q000627:therapeutic use; D018579:Patient Selection; D011446:Prospective Studies; D018570:Risk Assessment; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D020217:Vertebral Artery Dissection / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D014715:Vertebrobasilar Insufficiency / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D000759:Adjuvants, Anesthesia; D000959:Antihypertensive Agents; D009529:Nicardipine; D005283:Fentanyl