Cerebrovascular Department of Interventional Center, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Medicine (Baltimore). 2022 Nov 25;101(47):e31444. doi: 10.1097/MD.0000000000031444.
Intracranial vertebrobasilar dissecting aneurysms (VBDAs) are associated with a greater tendency to rupture and a greater risk of worse outcomes than anterior circulation aneurysms. Spontaneous healing of a VBDA is very rare, and there have been very few case reports of spontaneous healing of an aneurysm. We describe a case of intracranial vertebral artery dissecting aneurysm that healed spontaneously and disappeared completely on follow-up images.
A 40-years-old woman was referred to the neurology department because of a persistent headache, especially in the left occiput.
Magnetic resonance angiography and computed tomography angiography showed a left vertebral artery dissection-like aneurysm (4.5 × 2.0 × 2.5 mm in size) with proximal parent artery mild stenosis (40%).
Flunarizine hydrochloride was administered for symptomatic treatment and follow-up angiography was performed.
Digital subtraction angiography and magnetic resonance angiography showed that the aneurysm had completely disappeared at 3 months follow-up. High-resolution magnetic resonance vessel wall imaging revealed intimal thickening and mild stenosis in the left intracranial vertebral artery without an aneurysm signal. In addition, enhancement scanning revealed that the aneurysm area was moderately enhanced. MR-vessel wall imaging at 7 months follow-up showed that the enhancement was slightly reduced compared with the previous time.
This case illustrates the relatively plastic nature of a vertebral dissecting aneurysm, indicating that spontaneous healing remains possible.
颅内椎基底动脉夹层动脉瘤（VBDAs）比前循环动脉瘤更容易破裂，且预后更差。VBDA 自发性愈合非常罕见，仅有少数 VBDA 自发性愈合的病例报告。我们描述了一例颅内椎动脉夹层动脉瘤，其自发性愈合，随访影像学检查完全消失。
一名 40 岁女性因持续性头痛（尤其是左侧枕部）就诊于神经内科。
磁共振血管造影和计算机断层血管造影显示左侧椎动脉夹层样动脉瘤（4.5×2.0×2.5mm 大小），近端母动脉轻度狭窄（40%）。
给予盐酸氟桂利嗪对症治疗，并进行随访血管造影。
数字减影血管造影和磁共振血管造影显示，3 个月随访时动脉瘤完全消失。高分辨率磁共振血管壁成像显示左侧颅内椎动脉内膜增厚伴轻度狭窄，未见动脉瘤信号。此外，增强扫描显示动脉瘤区域中度强化。7 个月随访的 MR 血管壁成像显示，与前次相比，增强程度略有降低。
该病例提示椎动脉夹层动脉瘤具有一定的可塑性，表明其自发性愈合仍有可能。
