Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Other Publications
    • ajnr

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
Research ArticleINTERVENTIONAL

Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke

N. Kobayashi, Y. Murayama, I. Yuki, T. Ishibashi, M. Ebara, H. Arakawa, K. Irie, H. Takao, I. Kajiwara, K. Nishimura, K. Karagiozov and M. Urashima
American Journal of Neuroradiology March 2014, DOI: https://doi.org/10.3174/ajnr.A3873
N. Kobayashi
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Y. Murayama
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
I. Yuki
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
T. Ishibashi
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
M. Ebara
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
H. Arakawa
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
K. Irie
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
H. Takao
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
I. Kajiwara
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
K. Nishimura
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
K. Karagiozov
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
M. Urashima
From the Department of Neurosurgery (N.K., Y.M., I.Y., T.I., M.E., H.A., K.I., H.T., I.K., K.N., K.K.) and Division of Molecular Epidemiology (M.U.), The Jikei University School of Medicine, Tokyo, Japan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • PDF
Loading

Abstract

BACKGROUND AND PURPOSE: The natural history and therapeutic management of dissecting vertebrobasilar aneurysms without ischemic or hemorrhagic stroke (nonstroke dissecting vertebrobasilar aneurysms) are not well-established. We conservatively followed patients with nonstroke dissecting vertebrobasilar aneurysms and evaluated the factors related to clinical and morphologic deterioration.

MATERIALS AND METHODS: One hundred thirteen patients were enrolled and divided by clinical presentation at diagnosis: asymptomatic (group 1, n = 52), pain only (group 2, n = 56), and mass effect (group 3, n = 5). Patients were conservatively managed without intervention and antithrombotic therapy. Clinical outcomes and morphologic changes were analyzed.

RESULTS: A total of 113 patients who were diagnosed with nonstroke dissecting vertebrobasilar aneurysm had a mean follow-up of 2.9 years (range, 27 days to 8 years). Throughout that period, 1 patient in group 1 (1.9%) and 1 patient in group 2 (1.8%) showed clinical deterioration due to mass effect, and 1 patient in group 3 (20%) developed ischemic stroke followed by subarachnoid hemorrhage. Most patients (97.3%) were clinically unchanged. Three patients who had clinical deterioration showed aneurysm enlargement (P < .001). Aneurysms remained morphologically unchanged in 91 patients (80.5%). Aneurysm enlargement was seen in 5 patients (4.4%); risk of enlargement was significantly associated with either maximum diameter (hazard ratio = 1.30; 95% CI, 1.11–11.52; P = .001) or aneurysm ≥10 mm (hazard ratio = 18.0; 95% CI, 1.95–167; P = .011).

CONCLUSIONS: The natural course of these lesions suggests that acute intervention is not always required and close follow-up without antithrombotic therapy is reasonable. Patients with symptoms due to mass effect or aneurysms of >10 mm may require treatment.

Abbreviations

DVBA
dissecting vertebrobasilar aneurysm
  • © 2014 American Society of Neuroradiology
Next
Back to top
Advertisement
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke
N. Kobayashi, Y. Murayama, I. Yuki, T. Ishibashi, M. Ebara, H. Arakawa, K. Irie, H. Takao, I. Kajiwara, K. Nishimura, K. Karagiozov, M. Urashima
American Journal of Neuroradiology Mar 2014, DOI: 10.3174/ajnr.A3873

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Natural Course of Dissecting Vertebrobasilar Artery Aneurysms without Stroke
N. Kobayashi, Y. Murayama, I. Yuki, T. Ishibashi, M. Ebara, H. Arakawa, K. Irie, H. Takao, I. Kajiwara, K. Nishimura, K. Karagiozov, M. Urashima
American Journal of Neuroradiology Mar 2014, DOI: 10.3174/ajnr.A3873
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • The Fate of Unruptured Intracranial Vertebrobasilar Dissecting Aneurysm with Brain Stem Compression According to Different Treatment Modalities
  • Endovascular treatment for ruptured and unruptured vertebral artery dissecting aneurysms: a meta-analysis
  • Surpass Flow Diverter for Treatment of Posterior Circulation Aneurysms
  • Prognosis of carotid dissecting aneurysms: Results from CADISS and a systematic review
  • Imaging Characteristics of Growing and Ruptured Vertebrobasilar Non-Saccular and Dolichoectatic Aneurysms
  • Deconstructive and Reconstructive Techniques in Treatment of Vertebrobasilar Dissecting Aneurysms: A Systematic Review and Meta-Analysis
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Transradial Approach for Neuroendovascular Procedures: A Single-Center Review of Safety and Feasibility
  • Aneurysm Treatment in Acute SAH with Hydrophilic-Coated Flow Diverters under Single-Antiplatelet Therapy: A 3-Center Experience
  • Anatomic Snuffbox (Distal Radial Artery) and Radial Artery Access for Treatment of Intracranial Aneurysms with FDA-Approved Flow Diverters
Show more INTERVENTIONAL

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2020 Distinguished Reviewers
  • Press Releases

Resources

  • Evidence-Based Medicine Level Guide
  • How to Participate in a Tweet Chat
  • AJNR Podcast Archive
  • Ideas for Publicizing Your Research
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Share Your Art in Perspectives
  • Get Peer Review Credit from Publons
  • Moderate a Tweet Chat

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal
  • Position Statements

© 2021 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire