2018 Volume 40 Issue 3 Pages 179-184
Case 1: A 43-year-old man suddenly developed a headache. Head computed tomography revealed subarachnoid hemorrhage, and initial magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) showed the left vertebral artery (VA) occlusion. No other potential source of bleeding was detected. The next day, MRA showed recanalization of the left VA. Subsequent DSA showed irregular fusiform dilatation of the left VA, indicating recanalization of the VA dissecting aneurysm that was the bleeding source. Endovascular occlusion of the parent artery of the left VA was performed immediately. Case 2: A 63-year-old man presented with severe headache with obvious deterioration 2 days after onset. Head computed tomography revealed subarachnoid hemorrhage, and initial MRA showed right VA occlusion. Head MRA performed 7 h after the initial examination showed recanalization of the right VA, and DSA confirmed aneurysmal dilatation of the right VA. Craniotomy and trapping of the right VA were performed. In cases of a ruptured VA dissecting aneurysm with acute occlusion of the parent artery, close follow-up neuroimaging is essential because of the possibility of early recanalization of the VA.
