A Case of a De Novo Vertebral Artery Dissecting Aneurysm after Trapping of the Contralateral Vertebral Artery Dissecting Aneurysm

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  • MATSUI Hiroki
    Department of Neurological Surgery, Saiseikai Shigaken Hospital Department of Neurological Surgery, Shiga University of Medical Science
  • HINO Akihiko
    Department of Neurological Surgery, Saiseikai Shigaken Hospital
  • HIROTA Kengo
    Department of Neurological Surgery, Saiseikai Shigaken Hospital Department of Neurological Surgery, Tokyo Womens' Medical University Medical Center East
  • ECHIGO Tadashi
    Department of Neurological Surgery, Saiseikai Shigaken Hospital Department of Intensive Care, Saiseikai Sigaken Hospital
  • OKA Hideki
    Department of Neurological Surgery, Saiseikai Shigaken Hospital
  • HASHIMOTO Youichi
    Department of Neurological Surgery, Saiseikai Shigaken Hospital
  • NOZAKI Kazuhiko
    Department of Neurological Surgery, Shiga University of Medical Science

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  • 椎骨動脈解離性動脈瘤のトラッピング術後，対側椎骨動脈に新たに解離を生じた1例

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A 49 year-old man presented with right hemifacial spasm and right facial neuralgia caused by a giant thrombosed fusiform dissecting aneurysm in the right vertebral artery. The ipsilateral posterior inferior cerebellar artery was not involved in the aneurysm. Endovascular internal trapping with coils was performed 9 hours before he lost his consciousness, and computed tomography showed subarachnoid hemorrhage mainly in the posterior fossa. Digital subtraction angiography revealed a de novo dissecting aneurysm in the contralateral vertebral artery. He died 3 days after the endovascular procedure for the right giant aneurysm because of repeated subarachnoid hemorrhage. Autopsy and pathological examinations showed a newly developed ruptured dissecting aneurysm in the contralateral vertebral artery.<br>Ten cases of de novo vertebral artery dissecting aneurysms after trapping or occlusion of a dissecting aneurysm in the contralateral vertebral artery have been reported previously. We report our case and review of 11 reported cases, including ours.

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