Dissecting aneurysm of the vertebral artery causing subarachnoid hemorrhage after non-hemorrhagic infarction--case report

Neurol Med Chir (Tokyo). 2000 Dec;40(12):628-31. doi: 10.2176/nmc.40.628.


A 45-year-old male presented with lateral medullary infarction. Cerebral angiography showed dissecting aneurysm as pearl and string sign in the right vertebral artery (VA). Conservative treatment was administered with antiplatelet agent. However, subarachnoid hemorrhage occurred 2 days after admission, inducing coma. Intraaneurysmal embolization and proximal occlusion of the right VA by intravascular surgery resulted in only mild neurological deficits. Conservative treatment including strict control of blood pressure is the first choice of treatment. Antiplatelet therapy and anticoagulant therapy should not be administered. Patients must be followed up by serial angiography and surgery considered if signs of aneurysmal progression are seen.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Dissecting / diagnosis
  • Aneurysm, Dissecting / therapy*
  • Brain Stem Infarctions / diagnosis
  • Brain Stem Infarctions / surgery*
  • Diagnostic Imaging
  • Embolization, Therapeutic
  • Humans
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Subarachnoid Hemorrhage / diagnosis
  • Subarachnoid Hemorrhage / therapy*
  • Vertebral Artery / pathology*