Treatment Outcomes in Patients with a Vertebral Artery Dissecting Aneurysm

Cho, Tack Geun; Kim, Kyoung Tae; Suk, Jong Sik; Hong, Hyun Jong; Kwon, Jeong Taik; Kim, Young Baeg

Abstract

OBJECTIVE
The vertebral artery dissecting aneurysms have been increaslingly reported with recent advent of diagnostic tools. The authors analyzed the various therapeutic modalities according to the patient's clinical presentation.
METHODS
The clinical characteristics of vertebral artery dissecting aneurysm including clinical presentation, therapeutic modalities and outcomes were reviewed in eleven patients between March 2001 and August 2005.
RESULTS
Six patients were presented with subarachnoid hemorrhage and five patients with ischemia. Four patients were treated with endovascular coils or stent and one patient was treated with craniotomy and aneurysmal wrapping. The other six patients were treated conservatively. Clinical outcomes were relatively good (Glawsgow outcome scale > or = 4) except one patient (Glawsgow oucome scale = 3).
CONCLUSIONS
The treatment of a vertebral artery dissecting aneurysm must be choosed by characteristics of an aneurysm and the patient's clinical presentations. The patients with hemorrhage must be candidates for aggressive attempts to prevent rebleeding. On the other hand, the patients with ischemia may be good candidates for conservative treatment, and follow-up angiography is mandatory within three weeks after the symptom onset.