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Intracranial vertebral artery dissection presenting as subarachnoid hemorrhage: successful endovascular treatment

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Introduction– Intracranial vertebral artery dissection is a rare condition which may present as subarachnoid hemorrhage. In this situation, treatment is controversial. Case report– A case of intracranial right vertebral artery dissection in a 55-year-old woman presenting with subarachnoid hemorrhage is reported. The patient underwent therapeutic occlusion of the dissected artery through microcatheterization using pushing detachable platinum microcoils and had a good outcome. At this moment, the patient has a normal neurologic examination and a control digital subtraction angiography 1 year after the procedure showed an occluded right vertebral artery at V3; there was retrograde flow in the right intracranial vertebral artery up to the origin of a meningeal branch; the artery was thin and had mural irregularities, without any evidence of aneurismatic dilatation. Discussion– We review the literature and discuss the role of endovascular therapy and other therapeutic options in the treatment of this condition.
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Keywords: aneurysm clipping; aneurysm trapping; aneurysm wrapping; dissection; endovascular treatment; subarachnoid hemorrhage; vertebral artery

Document Type: Research Article

Affiliations: 1: Department of Neurology, Hospital das Clínicas, São Paulo University, São Paulo, Brazil, 2: Department of Radiology, Hospital das Clínicas, São Paulo University, São Paulo, Brazil

Publication date: 2001-01-01

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