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Vertebrobasilar dissection with subarachnoid hemorrhage: a retrospective study of 29 patients.

Ramgren, B; Cronqvist, Mats LU ; Romner, Bertil LU ; Brandt, Lennart LU ; Holtås, Stig LU and Larsson, Elna-Marie LU (2005) In Neuroradiology 47(2). p.97-104
Abstract
We have reviewed initial diagnostic features, treatment, and outcome in 29 patients with acute subarachnoid hemorrhage due to non-traumatic vertebrobasilar artery dissection diagnosed in our hospital between 1993 and 2003. The dissections occurred in the vertebral artery in 19 patients, the posterior inferior cerebellar artery ( PICA) in two patients, the basilar artery in four patients, and in the vertebral artery extending into the PICA in four patients. A pseudoaneurysm was found in 20 patients. Clinical manifestations typically included sudden onset of moderate to severe headache, nuchal rigidity, and drowsiness. Fourteen patients were treated conservatively. Fifteen patients underwent endovascular treatment with either parent artery... (More)
We have reviewed initial diagnostic features, treatment, and outcome in 29 patients with acute subarachnoid hemorrhage due to non-traumatic vertebrobasilar artery dissection diagnosed in our hospital between 1993 and 2003. The dissections occurred in the vertebral artery in 19 patients, the posterior inferior cerebellar artery ( PICA) in two patients, the basilar artery in four patients, and in the vertebral artery extending into the PICA in four patients. A pseudoaneurysm was found in 20 patients. Clinical manifestations typically included sudden onset of moderate to severe headache, nuchal rigidity, and drowsiness. Fourteen patients were treated conservatively. Fifteen patients underwent endovascular treatment with either parent artery occlusion ( 13 patients) or aneurysmal coil occlusion with preservation of the parent artery ( 2 patients). Re-bleeding occurred within 12 days and before treatment in nine patients. Eight of these had a pseudoaneurysm. No patient bled after endovascular treatment. Poor grade and early re-bleeding were associated with less favorable outcome. Outcome at 6 months did not differ significantly between endovascular and conservative treatment. Altogether, good recovery was achieved for 16 patients, moderate disability was seen in one, severe disability in four, and eight patients ( 27%) died. The absence of bleeding subsequent to endovascular treatment in this study suggests that endovascular treatment may be a rational approach in these patients at high risk of re-bleeding, especially those with a pseudoaneurysm. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
vertebrobasilar arteries, dissection, embolisation, subarachnoid hemorrhage
in
Neuroradiology
volume
47
issue
2
pages
97 - 104
publisher
Springer Verlag
external identifiers
  • pmid:15711986
  • wos:000227567500002
  • scopus:15844410506
ISSN
1432-1920
DOI
10.1007/s00234-005-1346-z
language
English
LU publication?
yes
id
913e9f74-fb29-4ca9-b059-12a3473b4d93 (old id 133750)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15711986&dopt=Abstract
date added to LUP
2007-07-24 16:55:29
date last changed
2017-09-03 03:38:53
@article{913e9f74-fb29-4ca9-b059-12a3473b4d93,
  abstract     = {We have reviewed initial diagnostic features, treatment, and outcome in 29 patients with acute subarachnoid hemorrhage due to non-traumatic vertebrobasilar artery dissection diagnosed in our hospital between 1993 and 2003. The dissections occurred in the vertebral artery in 19 patients, the posterior inferior cerebellar artery ( PICA) in two patients, the basilar artery in four patients, and in the vertebral artery extending into the PICA in four patients. A pseudoaneurysm was found in 20 patients. Clinical manifestations typically included sudden onset of moderate to severe headache, nuchal rigidity, and drowsiness. Fourteen patients were treated conservatively. Fifteen patients underwent endovascular treatment with either parent artery occlusion ( 13 patients) or aneurysmal coil occlusion with preservation of the parent artery ( 2 patients). Re-bleeding occurred within 12 days and before treatment in nine patients. Eight of these had a pseudoaneurysm. No patient bled after endovascular treatment. Poor grade and early re-bleeding were associated with less favorable outcome. Outcome at 6 months did not differ significantly between endovascular and conservative treatment. Altogether, good recovery was achieved for 16 patients, moderate disability was seen in one, severe disability in four, and eight patients ( 27%) died. The absence of bleeding subsequent to endovascular treatment in this study suggests that endovascular treatment may be a rational approach in these patients at high risk of re-bleeding, especially those with a pseudoaneurysm.},
  author       = {Ramgren, B and Cronqvist, Mats and Romner, Bertil and Brandt, Lennart and Holtås, Stig and Larsson, Elna-Marie},
  issn         = {1432-1920},
  keyword      = {vertebrobasilar arteries,dissection,embolisation,subarachnoid hemorrhage},
  language     = {eng},
  number       = {2},
  pages        = {97--104},
  publisher    = {Springer Verlag},
  series       = {Neuroradiology},
  title        = {Vertebrobasilar dissection with subarachnoid hemorrhage: a retrospective study of 29 patients.},
  url          = {http://dx.doi.org/10.1007/s00234-005-1346-z},
  volume       = {47},
  year         = {2005},
}