1991•Surgery for Cerebral StrokeOpen access

An Operation for the Dissecting Aneurysm of Vertebral Artery

Masamichi HASUE, Tadaharu Fukuda, Joo HARAOKA, Tetsuro MIWA

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Abstract

Fourteen cases of dissecting aneurysm of the vertebral artery are reported in this paper. Of these, twelve were cases of SAH, and two were cases of ischemia. Surgery was performed on the ten cases of SAH, and one of the ischemic cases. Eight of these surgeries were by proximal clip occlusion, two by trapping, and one by coating.Seven cases that underwent proximal clip occlusion experienced favorable results as GR, and one as MD. Except for one patient that underwent surgery in the acute period, all of these were operated on in the late period.The one patient who underwent tapping died after surgery due to angiospasm and pulmonary complications. The two patients with SAH, who had not undergone surgery, both hemorrhaged again 6 hours and 18 days after onset, and later died.It is thought that, because there are cases of dissecting vertebral aneurysm in which hemorrhaging reoccurs in the early stage, surgery at an early stage of the aneurysm, expect for the worst grade, is advisable.

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What this paper is about

Fourteen cases of dissecting aneurysm of the vertebral artery are reported in this paper. Of these, twelve were cases of SAH, and two were cases of ischemia. Surgery was performed on the ten cases of SAH, and one of the ischemic cases. Eight of these surgeries were by proximal clip occlusion, two by trapping, and one by coating.Seven cases that underwent proximal clip occlusion experienced favorable results as GR, and one as MD. Except for one patient that underwent surgery in the acute period, all of these were operated on in the late period.The one patient who underwent tapping died after surgery due to angiospasm and pulmonary complications. The two patients with SAH, who had not undergone surgery, both hemorrhaged again 6 hours and 18 days after onset, and later died.It is thought that, because there are cases of dissecting vertebral aneurysm in which hemorrhaging reoccurs in the early stage, surgery at an early stage of the aneurysm, expect for the worst grade, is advisable.

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Available abstract

Fourteen cases of dissecting aneurysm of the vertebral artery are reported in this paper. Of these, twelve were cases of SAH, and two were cases of ischemia. Surgery was performed on the ten cases of SAH, and one of the ischemic cases. Eight of these surgeries were by proximal clip occlusion, two by trapping, and one by coating.Seven cases that underwent proximal clip occlusion experienced favorable results as GR, and one as MD. Except for one patient that underwent surgery in the acute period, all of these were operated on in the late period.The one patient who underwent tapping died after surgery due to angiospasm and pulmonary complications. The two patients with SAH, who had not undergone surgery, both hemorrhaged again 6 hours and 18 days after onset, and later died.It is thought that, because there are cases of dissecting vertebral aneurysm in which hemorrhaging reoccurs in the early stage, surgery at an early stage of the aneurysm, expect for the worst grade, is advisable.

Key concepts: Medicine, Aneurysm, Surgery, Vertebral artery, Occlusion

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