Abstract |
We present a 49-year-old man with a subarachnoid haemorrhage from a dissecting vertebral artery (VA) pseudoaneurysm treated with a proximal balloon occlusion. The clinical course was complicated by the sudden appearance of a lateral medullary syndrome (Wallenberg), which completely resolved after anticoagulant therapy. During this course, CT-angiography (CTA) enabled monitoring of both the progression and partial resolution of the thrombus in the occluded VA. An anatomical variant of a perforating artery originating from the VA proximal to the posterior inferior cerebral artery ( PICA) was subsequently demonstrated, explaining the ischemic event. The value of CTA in clinical management is discussed. The prophylactic use of anticoagulant therapy especially in the case of a perforating artery to the lateral medulla originating proximally to the PICA, is suggested.
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Authors | Marco J T Verstegen, Frans-Jan H Hulsmans, Charles B L M Majoie, Gerrit J Bouma |
Journal | Clinical neurology and neurosurgery
(Clin Neurol Neurosurg)
Vol. 104
Issue 4
Pg. 371-6
(Sep 2002)
ISSN: 0303-8467 [Print] Netherlands |
PMID | 12140108
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Aneurysm, False
(complications, therapy)
- Angiography
(methods)
- Anticoagulants
(therapeutic use)
- Balloon Occlusion
(adverse effects)
- Humans
- Male
- Middle Aged
- Subarachnoid Hemorrhage
(complications, etiology)
- Thrombosis
(diagnostic imaging, etiology, prevention & control)
- Tomography, X-Ray Computed
(methods)
- Vertebral Artery Dissection
(complications, therapy)
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