Dissecting giant vertebro-basilar aneurysms

Childs Nerv Syst. 2003 Apr;19(4):204-10. doi: 10.1007/s00381-003-0726-0. Epub 2003 Mar 25.

Abstract

Object: Vertebro-basilar dissecting aneurysms (VDAs) are very rare in children. Strokes or subarachnoid hemorrhage are characteristic clinical manifestations, but often only non-specific symptoms are found. Radiological diagnosis may be difficult to obtain and therapy hard to perform. We report on a child who presented with an intracranial mass effect due to a giant VDA.

Methods: The patient was a 8-year-old girl with right hemiparesis, ataxia, dysphagia and dysphonia and worsening of her neurological deficits. Neuroimaging discovered a giant dissecting aneurysm arising from the left vertebral artery and involving the vertebro-basilar junction. Endovascular treatment by coil embolization was performed. The post-operative course initially showed a remarkable improvement in her clinical condition. Afterwards, she developed cerebral hemorrhage and died.

Conclusion: VDAs may have an unusual presentation and their therapy still remains a challenge. Endovascular embolization is a valid option but, as it is surgery, it may cause the death of the patient.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aneurysm, Dissecting* / diagnostic imaging
  • Aneurysm, Dissecting* / therapy
  • Basilar Artery*
  • Cerebral Angiography
  • Child
  • Embolization, Therapeutic / methods
  • Fatal Outcome
  • Female
  • Humans
  • Intracranial Aneurysm* / diagnostic imaging
  • Intracranial Aneurysm* / therapy
  • Magnetic Resonance Imaging
  • Tomography, X-Ray Computed
  • Vertebral Artery*