Management of spontaneous haemorrhagic intracranial vertebrobasilar dissection: review of 21 consecutive cases

Zhao, Wenpeng; Krings, Timo; Álvarez, H.; Ozanne, Augustin; Holmin, Staffan; Lasjaunias, P.

doi:10.1007/s00701-007-1161-x

Cited by 59 publications

(65 citation statements)

References 33 publications

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“…During the past 10 years, there have been a significant number of investigations into the feasibility of this technique [1][2][3][4][5][6][7][8][9][10]. Some articles have described the stability of occlusions treated with detachable coils and the efficacy of providing protection against VAD recurrence and consequent bleeding [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Conventional surgical treatment includes trapping the aneurysm, proximal ligation of the vertebral artery (VA ), or wrapping the aneurysm. Previous reports have suggested that endovascular parent artery occlusion is a safe and effective treatment for VAD [1][2][3][4][5][6][7][8][9][10]. Although some case series have reported on the feasibility of stent replacement, endovascular internal trapping has been performed in most of the cases.…”

Section: Introductionmentioning

confidence: 99%

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Long-term clinical and radiological results of endovascular internal trapping in vertebral artery dissection

et al. 2012

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2 Abstract PurposePrevious reports have suggested that endovascular parent artery occlusion is an effective and safe procedure for the treatment of vertebral artery dissection (VAD). However, the results of long-term outcomes are still unclear. This study reviewed the clinical and imaging outcomes of patients with VAD treated by endovascular internal trapping. MethodsA total of 73 patients were treated for VAD by endovascular internal trapping between March 1998 and March 2011. Patients were regularly followed up by magnetic resonance imaging, magnetic resonance angiography, and clinical examinations. Clinical outcomes were evaluated using the modified Rankin Scale. ResultsForty-five patients had ruptured VADs, and 28 had unruptured VADs. Clinical follow-up of at least 6 months data were obtained for 61 patients (83.6%). The follow-up period ranged from 6 to 145 months (mean ± SD, 55.6 ± 8.9 months). Two patients with ruptured VADs had recurrence (2.74%). Cranial nerve paresis (CNP) was observed in 6 patients (8.21%), spinal cord infarction in 2 patients(2.74%) and a perforating artery ischemia was diagnosed in 7 patients (9.59%); all patients with CNP and 5 of the patients with partial Wallenberg syndrome experienced only temporary symptoms; 2 of the patients with partial Wallenberg syndrome had permanent neurological deficits. Despite their symptoms, most patients were in good general condition, as shown by their clinical scores. ConclusionsThe results of this study have proven that endovascular internal trapping is a stable and durable treatment for closure of VADs. Recanalization is rather rare and occurred only in ruptured cases., both within 3months after tnitial treatment without rupture. CNP were observed in 8.21%, perforating ischemia in 9.59%, and spinal cord infarction in 2.74%. The former two are temporaly, while the last can be a factor that affect mRS. Patients rated their quality of life as good, as corroborated by their posttreatment clinical score. Endovascular internal trapping for VAD is a therapy with a satisfactory long-term outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term clinical and radiological results of endovascular internal trapping in vertebral artery dissection

et al. 2012

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“…1,6,10,14,16) Rebleeding most often occurs during the acute phase in patients with ruptured aneurysms and is thought to be the strongest prognostic factor for a poor outcome. 1,10,14,17,20) To prevent fatal rebleeding, very early treatment for the ruptured VA dissecting aneurysm is required. 10,14,17) Endovascular occlusion has been accepted as a safe, minimally invasive, and reliable treatment for ruptured dissecting aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…1,10,14,17,20) To prevent fatal rebleeding, very early treatment for a ruptured VA dissecting aneurysm is required. 10,14,17) On the other hand, some cases of VA dissecting aneurysms have been followed by spontaneous acute occlusion and early recanalization.…”

Section: Introductionmentioning

confidence: 99%

Acute Occlusion and Recanalization of Vertebral Artery Dissection After Subarachnoid Hemorrhage: Usefulness of Bilateral Simultaneous Vertebral Angiography and Basiparallel Anatomic Scanning-Magnetic Resonance Imaging

Yoshida

Ezura

Mino

2012

Neurol. Med. Chir.(Tokyo)

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A 41-year-old man presented with subarachnoid hemorrhage. Initial digital subtraction angiography showed occlusion of the right vertebral artery (VA), which recanalized immediately, and dissecting aneurysm on the distal part of the right VA. Basiparallel anatomic scanning (BPAS)-magnetic resonance (MR) imaging showed the morphology of the aneurysm clearly. Coil embolization of the entire affected artery was performed using bilateral vertebral angiography road mapping. Although acute occlusion of ruptured VA dissection may have the potential for natural healing, spontaneous recanalization seems to be hazardous because of rebleeding. In cases with acute occlusion of parent artery, BPAS-MR imaging and bilateral simultaneous vertebral angiography may give useful information.

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“…Vertebral artery (VA) dissection is a less frequent cause of SAH; however, it is increasingly recognized as a cause of stroke and SAH. [3][4][5] was 13.5 mg/L, and the hemoglobin had decreased from 13.5 g/dL to 9.8 g/dL. Initially, he underwent transcatheter arterial embolization, and 2 abnormal feeding vessels in the left upper lobe were embolized.…”

Section: Introductionmentioning

confidence: 99%

Subarachnoid Hemorrhage due to Vertebral Artery Dissection after Lung Resection

Maeda

Okada

Sakurada

et al. 2012

ATCS

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A 52-year-old man with massive hemoptysis underwent a left upper lobectomy. He suddenly reported a severe headache and lost consciousness on postoperative day 4. Computed tomography of the brain demonstrated a subarachnoid hemorrhage due to right vertebral artery dissection. Fortunately, he recovered well with intensive neurosurgical treatment. Vertebral artery dissection sometimes develops following systemic vascular disease, infection, and even minor neck trauma such as hyperextension or torsion of the neck. We should be aware that vertebral artery dissection may cause postoperative stroke and subarachnoid hemorrhage.

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Management of spontaneous haemorrhagic intracranial vertebrobasilar dissection: review of 21 consecutive cases

Cited by 59 publications

References 33 publications

Long-term clinical and radiological results of endovascular internal trapping in vertebral artery dissection

Long-term clinical and radiological results of endovascular internal trapping in vertebral artery dissection

Acute Occlusion and Recanalization of Vertebral Artery Dissection After Subarachnoid Hemorrhage: Usefulness of Bilateral Simultaneous Vertebral Angiography and Basiparallel Anatomic Scanning-Magnetic Resonance Imaging

Subarachnoid Hemorrhage due to Vertebral Artery Dissection after Lung Resection

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