Document Detail


Bilateral vertebral artery dissecting aneurysm with subarachnoid hemorrhage treated with staged bilateral vertebral artery coil occlusion: a case report.
MedLine Citation:
PMID:  18207505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Akihiro Inoue; Kanehisa Kohno; Akihiko Takechi; Keiji Kohno; Toshinori Matsushige; Tetsuji Takeda
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-01-22
Journal Detail:
Title:  Surgical neurology     Volume:  70     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-11     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  319-22; discussion 322     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Ehime Prefectural Central Hospital, Kasuga-machi 83, Matsuyama-shi, Ehime-Prefecture 790-0024, Japan. iakihiro@m.ehime-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Brain / blood supply
Cerebellopontine Angle / pathology,  surgery
Cerebral Angiography
Cerebrovascular Circulation / physiology
Embolization, Therapeutic / instrumentation*,  methods*
Female
Humans
Intracranial Aneurysm / pathology,  physiopathology,  therapy*
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Middle Aged
Prostheses and Implants / standards*
Subarachnoid Hemorrhage / pathology,  physiopathology,  therapy*
Tomography, X-Ray Computed
Treatment Outcome
Vertebral Artery / pathology,  radiography
Vertebral Artery Dissection / pathology,  physiopathology,  therapy*
Vertebrobasilar Insufficiency / etiology,  physiopathology,  surgery

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