Dissecting aneurysms of the vertebrobasilar system: Study of 16 cases

Eugenio Pozzati, Alvaro Andreoli, Paolo Limoni, Mario Casmiro

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In the last 14 years we have encountered 16 patients with spontaneous intracranial dissections of the vertebrobasilar (VB) system (mean age was 46 years and male/female ratio was 10/6). VB dissections presented in eight cases with subarachnoid bleeding and in eight with brainstem, cerebellar, or cerebral ischemia. Three patients had multiple dissections. Ten dissections occurred in the vertebral artery (two extended to the basilar artery), three in the posterior cerebral artery (one bilateral), two in the basilar artery, and one in the posterior inferior cerebellar artery. The angiographic configuration included "string" sign, "pearl and string" sign, fusiform dilation, and double lumen. The following angiographic evolution (available in 11 cases) was that of complete healing (three cases), partial resolution (five cases), progression (one case), and unimproving (two cases). Three patients died (two due to recurrent subarachnoid hemorrhage): two patients were explored surgically (one had further intravascular therapeutic embolization), and the rest were treated conservatively. Not all dissecting aneurysms fared in the same manner, depending either on the location in the VB circulation or on the variable vascular configuration: treatment should be fitted to the timing of diagnosis.

Original languageEnglish
Pages (from-to)119-124
Number of pages6
JournalSurgical Neurology
Issue number2
Publication statusPublished - 1994


  • Cerebral angiography
  • Dissecting aneurysm
  • Subarachnoid hemorrhage
  • Vertebral artery
  • Vertebrobasilar ischemia

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery


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