Patients in good clinical condition with symptomatic cerebral aneurysms were commonly misdiagnosed. Misdiagnosed patients were more likely than correctly diagnosed patients to deteriorate clinically and had a worse overall outcome. Misdiagnosed cases accounted for a significant fraction of overall poor outcomes among consecutive cases of symptomatic aneurysms.
A thirty-eight-year-old man with extensive spontaneous vertebrobasilar dissection in asso ciation with duplication of the ipsilateral proximal vertebral artery is described. He had no relevant medical history. The development of a spontaneous arterial dissection in a duplicated arterial system suggests a pathoetiologic association that may further expand the list of cerebrovascular pathology occurring with fenestration/duplications.
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