Uda Takehiro, Hayasaki Koji, Masamura Seiya, Nakanishi Naruhiko, Inoue Tsuyoshi, Ohata Kenji
Department of Neurosurgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
No Shinkei Geka. 2009 Nov;37(11):1111-6.
We report a rare case of a ruptured vertebral artery dissecting aneurysm (VADA) with affected vertebral artery (VA) occlusion. A 66-year-old hypertensive man presented with subarachnoid hemorrhage. No cerebeller sign or cranial nerve palsy was found on admission. Initial CT angiography and digital subtraction angiography (DSA) revealed the right VA occlusion. On the three days after onset, the right VA was recanalized and visualized as a posterior inferior cerebellar artery (PICA)-involved VADA. Endovascular internal trapping of the right VA including PICA origin was performed. In conclusion, it is essential that patients of VA occlusion associated with subarachnoid hemorrhage should be carefully diagnosed considering the possibility of VADA.
我们报告了一例罕见的椎动脉夹层动脉瘤（VADA）破裂并伴有患侧椎动脉（VA）闭塞的病例。一名66岁的高血压男性因蛛网膜下腔出血就诊。入院时未发现小脑体征或脑神经麻痹。初始CT血管造影和数字减影血管造影（DSA）显示右侧VA闭塞。发病三天后，右侧VA再通并显示为累及小脑后下动脉（PICA）的VADA。对包括PICA起始部在内的右侧VA进行了血管内原位栓塞。总之，对于伴有蛛网膜下腔出血的VA闭塞患者，必须仔细诊断，考虑VADA的可能性。
