title: Delayed subarachnoid hemorrhage 7 years after cerebellar infarction from traumatic vertebral artery dissection.
abstract: Vertebral artery dissection (VAD) is an important cause of ischemic stroke and subarachnoid hemorrhage (SAH). Dissections presenting with ischemia rarely cause SAH after more than a few hours, especially without radiographic evidence of pseudoaneurysm. We successfully treated a patient for persistent vessel injury presenting with SAH 7 years after presenting with extracranial subocclusive dissection of the right vertebral artery and an associated right posterior inferior cerebellar artery stroke. This is one of only three reported cases of delayed SAH occurring more than 2 weeks after an initial ischemic presentation of a VAD, and the only one without radiographic evidence of pseudoaneurysm at standard follow-up duration.
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Michael A
authors.identifier: http://orcid.org/0000-0001-8885-522X
authors.initials: MA
authors.lastname: Silva
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Alfred P
authors.identifier: http://orcid.org/0000-0003-3634-4692
authors.initials: AP
authors.lastname: See
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Priyank
authors.identifier: http://orcid.org/0000-0002-8350-9229
authors.initials: P
authors.lastname: Khandelwal
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Nirav J
authors.initials: NJ
authors.lastname: Patel
authors.affiliation: Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Aziz-Sultan
mesh_terms: D020520:Brain Infarction / Q000150:complications* / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D020217:Vertebral Artery Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery
keywords: CT Angiography; Coil; Dissection; Hemorrhage; Stroke