Nontraumatic dissecting aneurysm of the vertebral artery

Case report

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✓ A case is described of a nontraumatic dissecting aneurysm of the vertebral artery, which presented as a subarachnoid hemorrhage (SAH). Differentiation from vasospasm and from atherosclerosis is critical. Dissection between the adventitia and media should be noted in the differential diagnosis of SAH when an aneurysm or vascular malformation is not demonstrated angiographically.

Article Information

Address reprint requests to: Howard J. Senter, M.D., 4815 Liberty Avenue, Suite 401, Pittsburgh, Pennsylvania 15224.

© AANS, except where prohibited by US copyright law.

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Figures

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    Left vertebral arteriogram showing the narrow lumen of the left vertebral artery (thick arrow). The peculiar loop at the origin of the posterior inferior cerebellar artery (zigzag arrow) was misinterpreted as an aneurysm.

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    Metrizamide computerized tomography scan of the posterior fossa showing a fusiform enlargement of the left vertebral artery (arrow). The contralateral vertebral artery is normal (arrowhead). Poor flow of the metrizamide in the subarachnoid spaces of the left cerebellar hemisphere is related to edematous swelling.

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    Schematic view of the operative and angiographic findings. PICA = posterior inferior cerebellar artery; SAH = subarachnoid hemorrhage.

References

  • 1.

    Friedman WADay ALQuisling RGet al: Cervical carotid dissecting aneurysms. Neurosurgery 7:2072131980Friedman WA Day AL Quisling RG et al: Cervical carotid dissecting aneurysms. Neurosurgery 7:207–213 1980

    • Search Google Scholar
    • Export Citation
  • 2.

    Grosman HFornasier VLBonder Det al: Dissecting aneurysm of the cerebral arteries. Case report. J Neurosurg 53:6936971980Grosman H Fornasier VL Bonder D et al: Dissecting aneurysm of the cerebral arteries. Case report. J Neurosurg 53:693–697 1980

    • Search Google Scholar
    • Export Citation
  • 3.

    Hayman JAAnderson RM: Dissecting aneurysm of the basilar artery. Med J Aust 2:3603611966Hayman JA Anderson RM: Dissecting aneurysm of the basilar artery. Med J Aust 2:360–361 1966

    • Search Google Scholar
    • Export Citation
  • 4.

    Kunze SSchiefer W: Angiographic demonstration of a dissecting aneurysm of the middle cerebral artery. Neuroradiology 2:2012061971Kunze S Schiefer W: Angiographic demonstration of a dissecting aneurysm of the middle cerebral artery. Neuroradiology 2:201–206 1971

    • Search Google Scholar
    • Export Citation
  • 5.

    O'Dwyer JAMoscow NTrevor Ret al: Spontaneous dissection of the carotid artery. Radiology 137:3793851980O'Dwyer JA Moscow N Trevor R et al: Spontaneous dissection of the carotid artery. Radiology 137:379–385 1980

    • Search Google Scholar
    • Export Citation
  • 6.

    Waga SFujimoto KMorooka Y: Dissecting aneurysm of the vertebral artery. Surg Neurol 10:2372391978Waga S Fujimoto K Morooka Y: Dissecting aneurysm of the vertebral artery. Surg Neurol 10:237–239 1978

    • Search Google Scholar
    • Export Citation
  • 7.

    Yonas HAgamanolis DTakaoka Yet al: Dissecting intracranial aneurysms. Surg Neurol 8:4074151977Yonas H Agamanolis D Takaoka Y et al: Dissecting intracranial aneurysms. Surg Neurol 8:407–415 1977

    • Search Google Scholar
    • Export Citation

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