山口　浩司
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Case report
Language English
Peer review Peer reviewed
Title Stent-assisted coil embolisation for bilateral vertebral artery dissecting aneurysms presenting with subarachnoid haemorrhage.
Journal Formal name：The neuroradiology journal
Abbreviation：Neuroradiol J
ISSN code：23851996/19714009
Domestic / ForeginForegin
Volume, Issue, Page 29(6),pp.473-478
Author and coauthor Ishikawa Tatsuya†, Yamaguchi Koji, Anami Hidenori, Ishiguro Taichi, Matsuoka Go, Kawamata Takakazu
Publication date 2016/12
Summary Bilateral dissecting aneurysms presenting with subarachnoid haemorrhage are rare. The treatment strategy for bilateral vertebral artery dissecting aneurysms is controversial because the contralateral vertebral artery is already dissected and can easily undergo enlargement or bleed after non-reconstructive treatment procedures such as trapping or proximal occlusion. Here, we report a case of bilateral vertebral artery dissecting aneurysm presenting with subarachnoid haemorrhage that was treated with stent-assisted coiling for the ruptured side. A 42-year-old man was admitted to our hospital with sudden headache (WFNS grade 1). Computed tomography showed a high-density region in the basal cistern and posterior fossa with more haemorrhage on the right side (Fisher group 3). Three-dimensional computed tomography and three-dimensional rotational angiography demonstrated a bilateral round protrusion on the vertebral arteries with a diameter of 5 mm just distal to the posterior inferior cerebellar artery. Stent-assisted coiling was performed for the ruptured right side and conservative therapy was selected for the contralateral side. The ruptured side was well embolised, and the contralateral side was stable over the 12-month follow-up period after treatment. The treatment strategy for bilateral vertebral artery dissecting aneurysms presenting with subarachnoid haemorrhage is different from that for unilateral vertebral artery dissecting aneurysms. Non-reconstructive treatment procedures such as trapping may cause contralateral enlargement or rupture; therefore, reconstructive treatment may be appropriate for the ruptured side.
DOI 10.1177/1971400916666559
PMID 27558993