Internal trapping for ruptured vertebral artery dissecting aneurysm proximal to the posterior inferior cerebellar artery results in infarctions associated with basilar artery fenestration

Abstract

We describe a case where internal trapping performed for ruptured vertebral artery dissecting aneurysm on the proximal side of the posterior inferior cerebellar artery resulted in infarctions due to basilar artery fenestration. A 53-year-old woman sustained subarachnoid hemorrhage. Radiographic examinations revealed ruptured left vertebral artery dissecting aneurysm on the proximal side of the posterior inferior cerebellar artery with basilar artery fenestration. Although internal trapping was performed, it caused infarction on the left cerebellar and medulla oblongata. These results could be attributable to the anatomical features of basilar artery fenestration. The embolization of ruptured vertebral artery dissecting aneurysm with basilar artery fenestration should be performed with care while paying attention to its anatomical features and perfusion.