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Bilateral vertebral artery dissecting aneurysm with subarachnoid hemorrhage treated with staged bilateral vertebral artery coil occlusion: a case report.

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Bilateral vertebral artery dissecting aneurysm with subarachnoid hemorrhage treated with staged bilateral vertebral artery coil occlusion: a case report.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Inoue, Akihiro Kohno, Kanehisa Takechi, Akihiko Kohno, Keiji Matsushige, Toshinori Takeda, Tetsuji
Description	Country affiliation: Japan Author Affiliation: Inoue A ( Department of Neurosurgery, Ehime Prefectural Central Hospital, Kasuga-machi 83, Matsuyama-shi, Ehime-Prefecture 790-0024, Japan. iakihiro@m.ehime-u.ac.jp)
Abstract	BACKGROUND: Vertebral artery dissecting aneurysm is now increasingly recognized as a cause of posterior circulation stroke in young adults. Here, we report a case of bilateral VADA with SAH, treated by bilateral coil occlusion using GDCs. CASE DESCRIPTION: A 64-year-old woman was admitted to our hospital with consciousness disturbance (Hunt and Kosnik: grade 4). Computed tomography showed diffuse SAH with a thick hematoma in the left C-P angle. Magnetic resonance angiography, 3D-CTA, and cerebral angiography revealed bilateral VADAs. First, the ruptured left VADA involving the PICA and a perforating branch was treated by occluding the lower half of the VADA and the proximal VA with GDCs in the acute stage. Thereafter, the residual VADA and contralateral VADA exhibited enlargement on cerebral angiography and MRA for 2 months after the initial surgery; thus, the right VADA was occluded by GDCs just proximal to the right PICA after confirming BTO tolerance. CONCLUSION: Staged bilateral VA coil occlusions combined with BTO may be one of the treatment strategies for bilateral VADA with SAH in cases presenting surgical difficulty due to anatomical factors or severe grade of SAH.
File Format	HTM / HTML
ISSN	00903019
Issue Number	3
Volume Number	70
e-ISSN	18793339
Journal	Surgical Neurology
Language	English
Publisher	Elsevier
Publisher Date	2008-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Neurosurgery Embolization, Therapeutic Instrumentation Methods Intracranial Aneurysm Therapy Prostheses And Implants Standards Subarachnoid Hemorrhage Vertebral Artery Dissection Brain Blood Supply Cerebellopontine Angle Pathology Surgery Cerebral Angiography Cerebrovascular Circulation Physiology Female Humans Physiopathology Magnetic Resonance Angiography Magnetic Resonance Imaging Middle Aged Tomography, X-ray Computed Treatment Outcome Vertebral Artery Vertebrobasilar Insufficiency Etiology Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Neurology (clinical) Surgery

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