Alexiades Nikita G, Ellis Jason A, Meyers Philip M, Connolly E Sander
Department of Neurological Surgery, Columbia University Medical Center, New York, New York, USA.
Department of Radiology and Neurological Surgery, Columbia University, New York, New York, USA.
BMJ Case Rep. 2015 May 12;2015:bcr2015011740. doi: 10.1136/bcr-2015-011740.
The natural history of spontaneous cerebral artery dissection and thrombosis remains uncertain. Concurrent subarachnoid hemorrhage further complicates the therapeutic approach. Thus the best strategy for managing patients with acute vessel thrombosis in the setting of subarachnoid hemorrhage is unclear. Here we present a case of spontaneous posterior inferior cerebellar artery dissection presenting with subarachnoid hemorrhage and acute thrombosis. Although the patient was initially managed conservatively, angiographic follow-up demonstrated recanalization of the diseased vessel, necessitating definitive treatment. Thus we propose that angiographic follow-up is necessary in the management of patients with subarachnoid hemorrhage in association with apparent vessel thrombosis.
自发性脑动脉夹层和血栓形成的自然病程仍不明确。同时发生的蛛网膜下腔出血使治疗方法更加复杂。因此，对于蛛网膜下腔出血情况下急性血管血栓形成患者的最佳管理策略尚不清楚。在此，我们报告一例自发性小脑后下动脉夹层伴蛛网膜下腔出血和急性血栓形成的病例。尽管患者最初采用保守治疗，但血管造影随访显示病变血管再通，需要确定性治疗。因此，我们认为对于伴有明显血管血栓形成的蛛网膜下腔出血患者，血管造影随访在其管理中是必要的。
