title: Posterior atlantoaxial fusion as treatment option for extracranial vertebral artery dissecting aneurysm: a case report and literature review.
abstract: Symptomatic extracranial vertebral artery (VA) dissection may need surgery. We describe such a case successfully treated with atlantoaxial fusion based on its rare dynamic angiographic findings. A 27-year-old woman suffered from repeated brainstem and cerebellar infarctions from a left extracranial VA dissecting aneurysm. Dynamic angiography showed the dissecting aneurysm of the V3 segment in the neutral head position, and deflation of the aneurysm during rightward head rotation. She underwent posterior atlantoaxial fusion, and the lesion was repaired with no subsequent ischemia. Posterior atlantoaxial fusion can be an option for some extracranial VA dissections with preserving its anterograde blood flow.
authors.affiliation: Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, 2-4-20, Ohgimachi, Kita, Osaka, 530-8480, Japan.
authors.forename: Naokado
authors.initials: N
authors.lastname: Ikeda
authors.affiliation: Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, 2-4-20, Ohgimachi, Kita, Osaka, 530-8480, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, 2-4-20, Ohgimachi, Kita, Osaka, 530-8480, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Goto
authors.affiliation: Department of Neurology, Tazuke Kofukai Medical Research Institute and Kitano Hospital, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Satoi
authors.affiliation: Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, 2-4-20, Ohgimachi, Kita, Osaka, 530-8480, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Iwasaki
authors.affiliation: Department of Neurosurgery, Tazuke Kofukai Medical Research Institute and Kitano Hospital, 2-4-20, Ohgimachi, Kita, Osaka, 530-8480, Japan. htoda-nsu@umin.ac.jp.
authors.forename: Hiroki
authors.identifier: 0000-0002-1596-4131
authors.initials: H
authors.lastname: Toda
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000601:surgery*; D001268:Atlanto-Axial Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D013123:Spinal Fusion / Q000379:methods*; D020217:Vertebral Artery Dissection / Q000601:surgery*
keywords: Dissecting aneurysm; Extracranial vertebral artery; Posterior atlantoaxial fusion; Vertebrobasilar infarction