Article
Interdisciplinary management of patients presenting with subarachnoid hemorrhage due to vertebral artery dissecting aneurysms.
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Published: | June 4, 2012 |
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Outline
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Objective: The management and treatment of vertebral artery dissecting aneurysms is controversially discussed. We therefore analyzed our prospectively conducted neurovascular database concerning clinical characteristics, treatment modalities and functional outcome of patients suffering from SAH due to vertebral artery dissecting aneurysms.
Methods: From June 1999 to June 2011, 12 patients with spontaneous vertebral artery dissection were treated in our institution. Clinical and radiological characteristics were entered into a prospectively conducted database. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months.
Results: 8 patients (67%) were treated by a destructive technique by using proximal occlusion of the parent artery, whereas 4 patients (33%) were treated by a reconstructive technique using endovascular treatment modalities with preservation of the parent artery or complex vessel reconstruction by surgical clipping. Mean age was 56±6.1 years. Patients were in a poor neurological state at admission (mean Hunt & Hess grade 4.5±0.9). Favourable outcome (mRS 0–2) was achieved in 8 patients (67%).
Conclusions: We provide detailed data on interdisciplinary management of patients presenting with SAH caused by vertebral dissecting aneurysms. Despite poor-grade clinical status at admission, favourable outcome was achieved in a considerable number of patients.