Benign arterial dissections of the posterior circulation

J Neurosurg. 1991 Jul;75(1):69-72. doi: 10.3171/jns.1991.75.1.0069.

Abstract

Four young adults with spontaneous dissection of the vertebrobasilar system are reported. Clinically, two patients presented with subarachnoid hemorrhage and two with brain-stem ischemia. In two cases of ruptured arterial dissection of the posterior cerebral artery, angiography demonstrated fusiform and "sausage-like" dilatation of the involved vessel. In two cases of occlusive dissection of the basilar artery, angiography revealed the typical "string sign." All four patients were treated conservatively: three survive in good clinical condition and one remains disabled. Follow-up angiograms showed spontaneous healing of the lesion with return to an almost normal arterial configuration in two cases; residual narrowing corresponding to the dissection was the most notable finding in the other two. It is recommended that, in a subset of neurologically stable patients, angiographic monitoring is undertaken to assess the tendency for spontaneous repair before surgical intervention is planned.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, Dissecting / diagnostic imaging*
  • Basilar Artery / diagnostic imaging
  • Brain Ischemia / diagnostic imaging
  • Cerebral Angiography
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Male
  • Rupture, Spontaneous
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Vertebral Artery / diagnostic imaging