Extracranial vertebral artery pseudoaneurysm presenting as subarachnoid hemorrhage

Stuart S. Kaplan, Christopher S. Ogilvy, Ramon Gonzalez, Daryl Gress, John Pile-Spellman

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background and Purpose: True aneurysms of the extracranial vertebral artery are rare. The usual pathogenesis of aneurysms in this location is either penetrating or blunt trauma with resultant pseudoaneurysm formation. We report a postpartum patient with a presumed traumatic pseudoaneurysm of the extracranial vertebral artery presenting with subarachnoid hemorrhage. Case Description: A 41-year-old woman had three episodes of neck stiffness 1 month after an uncomplicated vaginal delivery. The last episode, 3 days before admission, was accompanied by intense neck and head pain and paresthesias that extended into the left arm, thumb, and forefinger. Results: Lumbar puncture showed subarachnoid hemorrhage. Angiography revealed a left vertebral artery dissection from C6-7 to C3 with pseudoaneurysm at C5-6. Computed tomography demonstrated impingement of the C6 root at the foramen by this lesion. The lesion was successfully treated by balloon occlusion of the vertebral artery. Conclusions: We present a patient with an extracranial vertebral pseudoaneurysm with subarachnoid hemorrhage and cervical root impingement. To our knowledge, this is the first case of such a lesion presenting as subarachnoid hemorrhage. The lesion was successfully treated using endovascular techniques.

Original languageEnglish (US)
Pages (from-to)1397-1399
Number of pages3
JournalStroke
Volume24
Issue number9
DOIs
StatePublished - Sep 1993

Keywords

  • Embolization, therapeutic
  • Subarachnoid hemorrhage
  • Vertebral artery

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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