Journal of neurosurgery
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The authors have reviewed their experience in the management of 55 patients admitted to Henry Ford Hospital with symptoms of vertebrobasilar insufficiency and associated proximal vertebral artery stenosis or occlusion. In 48 patients, the symptoms occurred as multiple repeated events, five of which resulted in permanent deficits. The remaining seven patients had single events, four of which caused permanent deficit. ⋯ Although the presentation of patients with vertebrobasilar insufficiency is generally characteristic, we believe that a specific diagnosis can be established only by angiographic means. Anticoagulants have been used to alleviate symptoms in some cases but are ineffective in solving the primary hemodynamic problem. Surgical reconstruction of the affected area deserves further evaluation in the management of these patients.
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Journal of neurosurgery · Nov 1984
Case ReportsIntracranial dissecting aneurysms of the posterior circulation. Report of six cases and review of the literature.
Dissecting aneurysms of the intracranial posterior circulation are unusual lesions that affect otherwise healthy young adults, are difficult to diagnose and manage, and carry a high morbidity and mortality rate. Headache in the suboccipital-posterior cervical region is the most common presenting symptom. The dissection usually occurs between the intima or internal elastic lamina and the media; subadventitial dissection does occur and accounts for the infrequent finding of subarachnoid hemorrhage. ⋯ The angiographic features are inconsistent, although an irregularly narrowed arterial segment with proximal and/or distal dilatation are typical findings. Depending on the location of the dissection, the surgical options are: ligation, trapping, or reinforcement of exposed abnormal portions of the vessel. Anticoagulation therapy is not indicated in the management of this lesion.