Delayed subarachnoid hemorrhage 7 years after cerebellar infarction from traumatic vertebral artery dissection

J Neurointerv Surg. 2017 Apr;9(4):e9. doi: 10.1136/neurintsurg-2016-012507.rep. Epub 2016 Jul 19.

Abstract

Vertebral artery dissection (VAD) is an important cause of ischemic stroke and subarachnoid hemorrhage (SAH). Dissections presenting with ischemia rarely cause SAH after more than a few hours, especially without radiographic evidence of pseudoaneurysm. We successfully treated a patient for persistent vessel injury presenting with SAH 7 years after presenting with extracranial subocclusive dissection of the right vertebral artery and an associated right posterior inferior cerebellar artery stroke. This is one of only three reported cases of delayed SAH occurring more than 2 weeks after an initial ischemic presentation of a VAD, and the only one without radiographic evidence of pseudoaneurysm at standard follow-up duration.

Keywords: CT Angiography; Coil; Dissection; Hemorrhage; Stroke.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic / trends
  • Brain Stem Infarctions / complications*
  • Brain Stem Infarctions / diagnostic imaging*
  • Brain Stem Infarctions / etiology
  • Humans
  • Male
  • Middle Aged
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Subarachnoid Hemorrhage / etiology*
  • Subarachnoid Hemorrhage / therapy
  • Time Factors
  • Vertebral Artery Dissection / complications*
  • Vertebral Artery Dissection / diagnostic imaging*
  • Vertebral Artery Dissection / etiology