Early spontaneous occlusion of a vertebral artery dissecting aneurysm caused by subarachnoid hemorrhage: A case report

Yoshio Suyama, MD,PhD; Ichiro Nakahara, MD,PhD; Shoji Matsumoto, MD,PhD; Jun Morioka, MD,PhD; Akiko Hasebe, MD; Jun Tanabe, MD; Sadayoshi Watanabe, MD; Kenichiro Suyama, MD; Kiyonori Kuwahara, MD,PhD

Radiology Case Reports (Jun 2022)

Early spontaneous occlusion of a vertebral artery dissecting aneurysm caused by subarachnoid hemorrhage: A case report

Yoshio Suyama, MD,PhD,
Ichiro Nakahara, MD,PhD,
Shoji Matsumoto, MD,PhD,
Jun Morioka, MD,PhD,
Akiko Hasebe, MD,
Jun Tanabe, MD,
Sadayoshi Watanabe, MD,
Kenichiro Suyama, MD,
Kiyonori Kuwahara, MD,PhD

Affiliations

Yoshio Suyama, MD,PhD: Corresponding author.; Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Ichiro Nakahara, MD,PhD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Shoji Matsumoto, MD,PhD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Jun Morioka, MD,PhD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Akiko Hasebe, MD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Jun Tanabe, MD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Sadayoshi Watanabe, MD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Kenichiro Suyama, MD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan
Kiyonori Kuwahara, MD,PhD: Department of Comprehensive Strokology, Fujita Health University, 1-98 Dengakugakubo, Toyoake, Aichi, 470-1192, Japan

Journal volume & issue: Vol. 17, no. 6
pp. 1977 – 1981

Abstract

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We report a case of vertebral artery dissecting aneurysm (VADA) that developed with subarachnoid hemorrhage and was found to be occluded based on subsequent digital subtraction angiography. Few reports have been published on ruptured VADA in which ipsilateral vertebral arteries are occluded. The proper management of this type of aneurysm is controversial. A 44-year-old woman developed a sudden onset headache. Computed tomography and three-dimensional computed tomography were immediately performed and showed subarachnoid hemorrhage and VADA distal to the right posterior inferior cerebellar artery bifurcation. We decided to treat the VADA immediately and performed digital subtraction angiography but found the VADA had spontaneously occluded. We performed coil embolization, including the aneurysm and the parent artery, with reference to the findings of three-dimensional computed tomography. On Day 16, recurrence was considered due to the finding of dilation of the distal end where the coil was embolized. An additional embolization was performed via the posterior communicating artery. No cases of endovascular treatment have been reported in VADA cases in which the rupture site is spontaneously occluded. In such cases, the treatment may be incomplete, so strict follow-up is required.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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