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aneurysm_vertebral

vertebral artery aneurysm

Introduction

  • these are rare aneurysms which usually develop intracranially at the junction of the vertebral artery and posterior inferior cerebellar artery (PICA) which account for 0.5-3% of intracranial aneurysms
  • they may also occur extracranially although these are very rare and most commonly follow penetrating trauma
    • the vertebral artery enters the cervical spine via the transverse foramina at C6, once it is passing up through the spine it is reasonably well protected
    • aneurysms may also form at the origin of the artery as it branches off the subclavian artery 1)

Aetiology

Clinical features of unruptured extracranial aneurysm

Clinical features of rupture

Investigation

  • MR angiography is the gold standard
  • if not available, CT angio

Treatment

  • high rates of rebleeding, morbidity, and mortality, poor treatment outcomes, as well as low rate of surgical treatment
  • prognosis is generally poor because the rupture rate is extremely high especially with large or giant aneurysms
  • although the natural history of unruptured VA dissection is still unknown, endovascular treatment should be considered for patients with a relatively large or growing aneurysmal dilatation because prognosis of the patients with subsequent SAH is poor.2)
aneurysm_vertebral.txt · Last modified: 2019/04/25 10:03 (external edit)