Fenestration of the Vertebral Artery (FVA) is a Rare Cerebrovascular Malformation of the Vertebral Artery (VA).

We describe a case of a ruptured VA dissecting aneurysm associated with the FVA

Abstract

A man in his 60s suffered sudden onset of headache and impaired consciousness. The diagnosis was a rupturedleft VA dissecting aneurysm extending from the bifurcation of the left posterior inferior cerebellar artery (PICA)to the VA union. In addition, FVA was observed. Proximal occlusion was indicated immediately after the PICAbifurcation, and the FVA was also occluded by direct clipping. The patient’s postoperative course was uneventful,and he was soon transferred to the rehabilitation hospital. FVA may be associated with aneurysms. Good outcomeswere obtained in our patient by occluding the dissecting aneurysm as well as the FVA. The possible presenceof FVA involved in the dissecting aneurysm should be considered when planning proximal occlusion by directoperation.