Neurological Surgery No Shinkei Geka Volume 32, Issue 7 (July 2004)

Dissecting Vertebral Aneurysm with Subarachnoid Hemorrhage after Ischemic Onset on the Same Day : A Case Report Akira YAMATAKI 1 , Yukiya KURASHIMA 1 , Shinsuke UEDA 1 1Department of Neurosurgery,Isogo Central & Neurosurgical Hospital Keyword: dissecting aneurysm , vertebral artery , subarachnoid hemorrhage , ischemia pp.723-728
Published Date 2004/7/1
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 We report a case of a dissecting vertebral aneurysm with subarachnoid hemorrhage (SAH) after ischemic onset on the same day. A 48-year-old man had abrupt vertigo and nausea. CT & MRI on admission showed no abnormality,but he complained of left hemiparesis after admission. Twelve hours after the ischemic onset he suddenly complained of severe headache and his consciousness deteriorated. The follow-up CT showed diffuse SAH. Cerebral angiography showed occlusion of the right vertebral artery at the origin of the posterior inferior cerebellar artery (PICA) and segmental stenosis of the left vertebral artery at the portion distal to the vertebral PICA junction. We treated the patient conservatively. Four days later,he suddenly fell into a coma,but CT showed no bleeding. Because of this we suspected brain stem ischemia due to deterioration of vertebral dissection. The patient died 8 hours after the ischemic reattack. We report difficulty of treatment of a dissecting vertebral aneurysm with simultaneous ischemia and subarachnoid hemorrhage.

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Neurological Surgery 脳神経外科
32巻7号 (2004年7月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院