title: Subarachnoid hemorrhage then thrombosis of posterior inferior cerebellar artery dissection: is early surgical exploration warranted?
abstract: The natural history of spontaneous cerebral artery dissection and thrombosis remains uncertain. Concurrent subarachnoid hemorrhage further complicates the therapeutic approach. Thus the best strategy for managing patients with acute vessel thrombosis in the setting of subarachnoid hemorrhage is unclear. Here we present a case of spontaneous posterior inferior cerebellar artery dissection presenting with subarachnoid hemorrhage and acute thrombosis. Although the patient was initially managed conservatively, angiographic follow-up demonstrated recanalization of the diseased vessel, necessitating definitive treatment. Thus we propose that angiographic follow-up is necessary in the management of patients with subarachnoid hemorrhage in association with apparent vessel thrombosis.
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, New York, USA.
authors.forename: Nikita G
authors.initials: NG
authors.lastname: Alexiades
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, New York, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Ellis
authors.affiliation: Department of Radiology and Neurological Surgery, Columbia University, New York, New York, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Meyers
authors.affiliation: Department of Neurological Surgery, Columbia University Medical Center, New York, New York, USA.
authors.forename: E Sander
authors.initials: ES
authors.lastname: Connolly
mesh_terms: D006801:Humans; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D011859:Radiography; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017287:Ventriculoperitoneal Shunt; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000601:surgery
keywords: Aneurysm; Angiography; Artery; Dissection; Hemorrhage