• Masahiro Oomura, Tadashi Terai, and Koji Shigeno.
• Department of Neurology, Shizuoka Municipal Shimizu Hospital.
• Rinsho Shinkeigaku. 2006 Feb 1; 46 (2): 160-2.

AbstractA 57-year-old woman had noticed occipital headache and neck pain bilaterally 6 weeks before admission. The headache and neck pain persisted for 3 weeks, then disappeared. Cranial magnetic resonance (MR) image obtained 4 weeks after the onset demonstrated intramural hematoma adjacent to intracranial left vertebral artery. MR image did not show any abnormal lesions in the brain parenchyma. Although cranial MR angiography did not show any definite aneurysms, three-dimensional CT angiography (3D-CTA) obtained 6 weeks after the onset disclosed an aneurysm of the left vertebral artery. The vessel distal to the aneurysm was occluded. Because the left posterior inferior cerebellar artery originated from the aneurysm, we did not perform embolization using coils. Spontaneous dissecting aneurysm of the left vertebral artery was diagnosed based on the clinical, MR image, and 3D-CTA findings. The systolic blood pressure was maintained under 130 mmHg using antihypertensive agents. Thereafter, 3D-CTA obtained 6 months after the onset showed recanalization of the occluded vessel distal to the aneurysm. The size of the aneurysm was unchanged. During these 6 months, there were no ischemic or hemorrhagic stroke events. In the present patient, headache and neck pain were the only manifestations of spontaneous dissection of the vertebral artery.

22 keywords...

hide…