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A Ruptured Vertebral Artery Dissecting Aneurysm Involving the Anterior Spinal Artery:A Case Report Nagatsuki TOMURA 1 , Kenichi KONO 4 , Hideo OKADA 1 , Ryo YOSHIMURA 2 , Aki SHINTANI 3 , Yuko TANAKA 4 , Tomoaki TERADA 4 1Department of Neurosurgery, Wakayama Rosai Hospital 2Department of Neurosurgery, Minami Wakayama Medical Center 3Department of Neurosurgery, Koyo Hospital 4Department of Neurosurgery, Showa University Fujigaoka Hospital Keyword: vertebral artery dissecting aneurysm , anterior spinal artery , endovascular treatment , subarachnoid hemorrhage pp.575-581
Published Date 2016/7/10
DOI https://doi.org/10.11477/mf.1436203333
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 A 50-year-old woman presented with a subarachnoid hemorrhage caused by a ruptured vertebral artery dissecting aneurysm(VADA)involving the anterior spinal artery(ASA). The ASA branched at the proximal component of the dissecting aneurysm. The rupture point was presumed to be the distal region of the dissecting aneurysm. We performed coil embolization of the distal part only in order to prevent rebleeding and preserve the ASA. The patient showed no neurological deficits. Six months after the procedure, an angiogram demonstrated occlusion of a distal portion of the right vertebral artery. However, the ASA was still patent. No rebleeding occurred, and the patient has remained neurologically symptom-free for 3 years from the treatment. ASA-involved VADAs are extremely rare. Treatment strategy is difficult because there are no options for bypass surgery and occlusion of the ASA may lead to quadriplegia unless there is collateral flow to the ASA. Although the outcome of the patient was good with partial coil embolization in this case, the treatment strategy should be carefully considered for ASA-involved VADAs.


Copyright © 2016, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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