AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on October 10, 2007
doi: 10.3174/ajnr.A0771
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Endovascular Treatment of Symptomatic Intradural Vertebral Dissecting Aneurysms

J.P.P. Pelusoa, W.J. van Rooija, M. Sluzewskia, G.N. Beuteb and C.B. Majoiec

a Departments of Radiology, St Elisabeth Ziekenhuis, Tilburg
b Neurosurgery, St Elisabeth Ziekenhuis, Tilburg
c Department of Radiology, Academisch Medisch Centrum, Amsterdam, the Netherlands


Figure 1
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  		Fig 1. Acutely ruptured left vertebral dissecting aneurysm proximal to the PICA origin in a 47-year-old man (patient #3). A, Left vertebral angiogram shows dissecting aneurysm on a narrowed segment proximal to the PICA origin (arrow). B, Right vertebral angiogram after internal coil trapping of the aneurysm and dissecting aneurysm demonstrates retrograde filling of the left distal vertebral artery and PICA (arrow).


Figure 2
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  		Fig 2. Right vertebral dissecting aneurysm involving the origin of the PICA in a 51-year-old man referred 4 weeks after SAH (patient #5). A, Right vertebral angiogram shows dissecting aneurysm. B, Follow-up angiogram 6 months after stent placement demonstrates complete occlusion of the aneurysm with a patent right PICA.


Figure 3
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  		Fig 3. Giant, partially thrombosed right vertebral dissecting aneurysm distal to the PICA origin occurring with acute compression of the brain stem in a 10-year-old boy (patient #8). A, MR imaging shows dissecting aneurysm compressing the brain stem. B,C, Right (B) and left (C) vertebral angiogram shows giant aneurysm of the right vertebral artery distal to the PICA origin. D,E, Bilateral vertebral angiograms (D) and corresponding radiograph (E) with complete coil occlusion of the aneurysm and parent vertebral segment. F, MR imaging 6 months later demonstrates shrinkage of the aneurysm with decreased compression of the brain stem.


Figure 4
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  		Fig 4. Acutely ruptured left vertebral dissecting aneurysm of a dominant vertebral artery in a 36-year-old woman presenting in HH IV (patient #9). A, Angiogram of the dominant left vertebral artery demonstrates a dissecting aneurysm distal to the PICA origin (long arrow) with focal narrowing. Note proximal basilar fenestration (short arrow). B, Right vertebral angiogram during test occlusion of the left vertebral artery shows adequate filling of posterior circulation vessels despite small caliber. C, Unsubstracted radiograph after internal coil trapping of the distal left vertebral artery.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X