Document Detail

Vertebrobasilar artery dissection presenting with simultaneous subarachnoid hemorrhage and brain stem infarction: case report.
MedLine Citation:
PMID:  12633950     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Intracranial dissecting aneurysms have been associated with subarachnoid hemorrhage (SAH) or cerebral ischemia. We encountered a patient presenting with simultaneous subarachnoid hemorrhage and brainstem infarction caused by a dissecting aneurysm of the vertebrobasilar artery, which was diagnosed by magnetic resonance imaging (MRI) but did not show abnormal findings on cerebral angiography. CASE DESCRIPTION: A 55-year-old man had sudden onset of headache and left abducens palsy. Computed tomography revealed a subarachnoid hemorrhage localized in the left prepontine cistern and the left cerebellomedullary fissure. Cerebral angiography showed neither a saccular aneurysm nor fusiform dilatation causing the subarachnoid hemorrhage. MRI demonstrated a small infarction in the left dorsal pons, and an intramural hematoma of the left vertebral artery and lower basilar artery. CONCLUSION: This is a rare case of a vertebrobasilar dissecting aneurysm that simultaneously caused both SAH and brain stem infarction. MRI should be performed in the acute phase of SAH of unknown origin to determine the possible coexistence of a dissecting aneurysm, as occurred in this case.
Kensuke Murakami; Noboru Takahashi; Nobuhisa Matsumura; Kunihiko Umezawa; Hiroshi Midorikawa; Michiharu Nishijima
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  59     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-03-13     Completed Date:  2003-03-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  18-22     Citation Subset:  IM    
Department of Neurosurgery, Aomori Prefectural Central Hospital, 2-1-1 Higashi-tsukurimichi, Aomori, Japan.
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MeSH Terms
Aneurysm, Dissecting / complications*,  diagnosis
Basilar Artery* / pathology,  radiography
Brain Stem Infarctions / diagnosis,  etiology*
Cerebral Angiography
Intracranial Aneurysm / complications*,  diagnosis
Magnetic Resonance Imaging
Middle Aged
Subarachnoid Hemorrhage / diagnosis,  etiology*
Tomography, X-Ray Computed
Vertebral Artery* / pathology,  radiography

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