Abstract
Four young adults with spontaneous dissection of the vertebrobasilar system are reported. Clinically, two patients presented with subarachnoid hemorrhage and two with brain-stem ischemia. In two cases of ruptured arterial dissection of the posterior cerebral artery, angiography demonstrated fusiform and 'sausage-like' dilatation of the involved vessel. In two cases of occlusive dissection of the basilar artery, angiography revealed the typical 'string sign.' All four patients were treated conservatively: three survive in good clinical condition and one remains disabled. Follow-up angiograms showed spontaneous healing of the lesion with return to an almost normal arterial configuration in two cases; residual narrowing corresponding to the dissection was the most notable finding in the other two. It is recommended that, in a subset of neurologically stable patients, angiographic monitoring is undertaken to assess the tendency for spontaneous repair before surgical intervention is planned.
Original language | English |
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Pages (from-to) | 69-72 |
Number of pages | 4 |
Journal | Journal of Neurosurgery |
Volume | 75 |
Issue number | 1 |
Publication status | Published - 1991 |
Keywords
- aneurysm, dissecting
- ischemia
- posterior circulation
- subarachnoid hemorrhage
- vertebrobasilar system
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)