Dissecting aneurysms of the basilar artery

Eugenio Pozzati, Alvaro Andreoli, Roberto Padovani, Giacomo Nuzzo

Research output: Contribution to journalArticle

Abstract

TEN PATIENTS (six men and four women; mean age, 40 yr) with spontaneous dissection of the basilar artery are reported. Clinically, six were admitted with subarachnoid hemorrhage (SAH) and four were admitted with brain stem ischemia. Angiography demonstrated string sign in four patients, pearl reaction in four, double lumen in one, and arterial ectasia with mural retention of contrast medium in one. Magnetic resonance imaging was performed in two patients. Follow-up angiograms or magnetic resonance angiography in six patients showed spontaneous healing in two patients, improvement in two, progression in one, and no change in one. Nine patients were treated medically, and one underwent selective intravascular occlusion of the dissecting aneurysm. One patient died after further SAH, two remain severely disabled, three have residual neurological deficit, and four are in good clinical condition. The most interesting observations in this series include a relatively good course in a substantial number of patients and low further bleeding potential after SAH, the late “globular” evolution, which may be favorable for reconstructive treatment, and the diagnostic value of associated computed tomographic/angiographic findings. Surgical options in basilar dissection are very poor; in some reported cases, wrapping has been tried with disappointing results. In light of the possibility of spontaneous healing or improvement, wrapping should be reserved for only those patients with recurrent SAH or angiographic progression of the dissection.

Original languageEnglish
Pages (from-to)254-258
Number of pages5
JournalNeurosurgery
Volume36
Issue number2
Publication statusPublished - 1995

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Keywords

  • Basilar artery
  • Cerebral angiography
  • Computed axial tomography
  • Dissecting aneurysms
  • Stroke
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Pozzati, E., Andreoli, A., Padovani, R., & Nuzzo, G. (1995). Dissecting aneurysms of the basilar artery. Neurosurgery, 36(2), 254-258.