Surgery for Cerebral Stroke
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
Topics: Surgical Strategy and Surgical Approach
Early Embolizations for the Poorest Grade Patients with Ruptured Dissecting Aneurysms of the Vertebral Artery
Kazunori AKAJITakenori AKIYAMAKenji HIRAGAYoshio TANIZAKIAtsuhiro KOJIMASyunichi OKUI
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2010 Volume 38 Issue 1 Pages 24-28

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Abstract
We report 5 patients (2 females and 3 males) with endovascular coil embolizations for ruptured dissecting aneurysms of the vertebral artery (VA). The age of the patients varies between 44 and 66 (mean 54.8) years. All patients had a Hunt and Kosnik Grade of V at admission. One patient had a dissecting aneurysm of the VA distal to the PICA. One patient had a dissecting aneurysm of the VA without the PICA. Three patients had a dissecting aneurysm of the VA involving the PICA. One patient with a dissecting aneurysm of the VA involving the PICA underwent proximal occlusion, and the other 4 patients underwent internal trapping. All patients underwent endovascular coil embolizations on the day or the next day of the onset. Subsequent rupture occurred in 4 patients before embolization. The Glasgow Outcome Scale at 3 months after the embolization was good recovery in 3 patients. We had no ruptured aneurysm and no coil compaction at 0 to 40 months (mean 26.2 months) after embolization. Our experience showed that the internal trapping for ruptured dissecting aneurysms of the vertebral artery should be performed as soon as possible, even if the patients have a Hunt and Kosnik Grade of V.
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© 2010 by The Japanese Society on Surgery for Cerebral Stroke
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