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Journal of Korean Neurosurgical Society 1995;24(6): 667-675.
Diagnosis and Management of the Vertebrobasilar Dissecting Aneurysm.
Han Sung Kim, Hyeon Seon Park, Jin Yang Joo, Dong Ik Kim, Kyu Chang Lee
1Department of Neurosurgery, Yonsei University, College of Medicine, Seoul, Korea.
2Department of Diagnostic Radiology, Yonsei University, College of Medicine, Seoul, Korea.
The authors have experienced seven cases of spontaneous intracranial dissecting aneurysm. Headache on the suboccipital region was the most common presenting symptom. Four patients had subarachnoid hemorrhage(SAH). Most of the patients were males:six men, one woman. The locations of the aneurysm were vertebral artery in six and basilar artery in one. An irregularly narrowed arterial segment with proximal and/or distal dilatation was the most significant angiographic findings. The introduction of MRI and DSA made the diagnosis of dissecting aneurysm easier in the suspicious cases with a traditional cerebral 4-vessel angiography. Five patients were treated surgically:Proximal clip occlusion of affected artery in three cases, trapping in one, wrapping combined with proximal clip occlusion in another. The surgical results were excellent in all the cases. There was no further dissection of affected artery on postoperative follow-up angiography.
Key Words: Dissecting aneurysm; SAH; DSA; MRI; Vertebro-basilar artery; Proximal clip occlusion
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