Recurrent Torticollis Caused by Dissecting Vertebral Artery Aneurysm in a Pediatric Patient: Results of Endovascular Treatment by Use of Coil Embolization: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (1) ◽  
pp. 204-208 ◽  
Author(s):  
Salvatore Grosso ◽  
Rosa Mostardini ◽  
Carlo Venturi ◽  
Sandra Bracco ◽  
Alfredo Casasco ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Coil Embolization ◽  
Brain Magnetic Resonance Imaging ◽  
Artery Aneurysm ◽  
Rare Condition ◽  
Vascular Lesions ◽  
Long Term Results ◽  
Left Vertebral Artery ◽  
Fourth Segment

ABSTRACT OBJECTIVE AND IMPORTANCE Torticollis is a symptom that can be related to different pathological mechanisms ranging from simple to life-threatening conditions. We report a child with recurrent torticollis caused by an intracranial dissecting vertebral artery aneurysm. This is a very rare condition in childhood, and it was resolved successfully with endovascular treatment. CLINICAL PRESENTATION The patient was a 10-year-old boy with a 4-year history of left recurrent torticollis, followed by hemiparesis, dysarthria, dysmetria, and tremor. Brain magnetic resonance imaging and digital angiography detected a dissecting aneurysm involving the fourth segment of the left vertebral artery. INTERVENTION The patient underwent endovascular treatment. Coil embolization, followed by histoacryl injection into the lesion, provided complete obliteration of the aneurysmal sac. CONCLUSION The patient's postoperative course was characterized by a dramatic disappearance of symptoms and signs within a few hours of the intervention. No relapses of symptoms occurred during a follow-up period of 18 months. This is the first report of a child in whom recurrent torticollis was related to a dissecting vertebral artery aneurysm. Although long-term results of vertebral artery coil embolization remain to be elucidated, the method seems reliable and effective in treatment of these vascular lesions in pediatric patients.

scholarly journals Supraclavicular area swelling in neurofibromatosis patient

2018 ◽  
Vol 25 (5) ◽  
pp. 298-300
Author(s):  
Duk Hee Lee ◽  
Jae Hee Lee ◽  
Keon Kim ◽  
Ji Yeon Lim ◽  
Yoon Hee Choi
Keyword(s):  
Vertebral Artery ◽  
Vascular Complications ◽  
Artery Aneurysm ◽  
Neurofibromatosis 1 ◽  
Vascular Lesions ◽  
Left Vertebral Artery ◽  
Left Shoulder ◽  
Vascular Abnormality ◽  
Threatening Condition ◽  
Life Threatening

Neurofibromatosis 1 is an autosomal dominant disorder characterized by cafe-au-lait spots, cutaneous neurofibroma, and bony deformities. Vascular abnormality such as stenosis, aneurysm, or rupture associated with neurofibromatosis 1 is rare. Rupture of vertebral artery aneurysm into the thoracic cavity is extremely rare. The outcomes of patients with aneurysmal ruptures are very poor when spontaneous hemothorax occur. A 31-year-old woman presented to the emergency department with left shoulder pain and with both lower chest wall pain and left supraclavicular area swelling. The chest computed tomography scan revealed about 4-cm pseudo-aneurysm probable arising from the left vertebral artery with large hematoma at left supraclavicular area. Neurofibromatosis 1 is generally being regarded as a benign disease but has the potential for serious vascular complications. When aneurysms were ruptured, cervical hematoma, hemothorax, or hypotension was developed. It is potentially a life-threatening condition, so it must require emergent management. Emergency physicians must remember the relation of neurofibromatosis 1 and serious vascular complications and ensure rapid access to rule out vascular lesions, so as to prevent the life-threatening condition.

Recurrence of a Vertebral Artery Dissecting Pseudoaneurysm after Successful Stent-supported Coil Embolization: Case Report

Neurosurgery ◽  
2003 ◽  
Vol 53 (3) ◽  
pp. 754-761 ◽  
Author(s):  
Christopher I. MacKay ◽  
Patrick P. Han ◽  
Felipe C. Albuquerque ◽  
Cameron G. McDougall
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Neck Pain ◽  
Vertebral Artery ◽  
Coil Embolization ◽  
Artery Aneurysm ◽  
Left Vertebral Artery ◽  
Parent Vessel ◽  
Computed Tomographic ◽  
Computed Tomographic Scan

Abstract OBJECTIVE AND IMPORTANCE Dissecting aneurysms of the intracranial vertebral artery are increasingly recognized as a cause of subarachnoid hemorrhage. We present a case involving technical success of the stent-supported coil embolization but with recurrence of the dissecting pseudoaneurysm of the intracranial vertebral artery. The implications for the endovascular management of ruptured dissecting pseudoaneurysms of the intracranial vertebral artery are discussed. CLINICAL PRESENTATION A 36-year-old man with a remote history of head injury had recovered functionally to the point of independent living. He experienced the spontaneous onset of severe head and neck pain, which progressed rapidly to obtundation. A computed tomographic scan of the head revealed subarachnoid hemorrhage centered in the posterior fossa. The patient underwent cerebral angiography, which revealed dilation of the distal left vertebral artery consistent with a dissecting pseudoaneurysm. INTERVENTION Transfemoral access was achieved under general anesthesia, and two overlapping stents (3 mm in diameter and 14 mm long) were placed to cover the entire dissected segment. Follow-up angiography of the left vertebral artery showed the placement of the stents across the neck of the aneurysm; coil placement was satisfactory, with no residual aneurysm filling. Approximately 6 weeks after the patient's initial presentation, he developed the sudden onset of severe neck pain. A computed tomographic scan showed no subarachnoid hemorrhage, but computed tomographic angiography revealed that the previously treated left vertebral artery aneurysm had recurred. Angiography confirmed a recurrent pseudoaneurysm around the previously placed Guglielmi detachable coils. A test balloon occlusion was performed for 30 minutes. The patient's neurological examination was stable throughout the test occlusion period. Guglielmi detachable coil embolization of the left vertebral artery was then performed, sacrificing the artery at the level of the dissection. After the procedure was completed, no new neurological deficits occurred. On the second day after the procedure, the patient was discharged from the hospital. He was alert, oriented, and able to walk. CONCLUSION We appreciate the value of preserving a parent vessel when a dissecting pseudoaneurysm of the intracranial vertebral artery ruptures in patients with inadequate collateral blood flow, in patients with disease involving the contralateral vertebral artery, or in patients with both. However, our case represents a cautionary note that patients treated in this fashion require close clinical follow-up. We suggest that parent vessel occlusion be considered the first option for treatment in patients who will tolerate sacrifice of the parent vessel along its diseased segment. In the future, covered stent technology may resolve this dilemma for many of these patients.

scholarly journals Endovascular Treatment of a Vertebral Artery Aneurysm via Puncture of the Surgically Exposed Vertebral Artery

2011 ◽  
Vol 17 (1) ◽  
pp. 74-77 ◽  
Author(s):  
F. Oka ◽  
H. Ishihara ◽  
S. Kato ◽  
M. Shinoyama ◽  
M. Suzuki
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Endovascular Therapy ◽  
Surgical Approach ◽  
Coil Embolization ◽  
Artery Aneurysm ◽  
Direct Access ◽  
Proximal Side ◽  
Femoral Route

We describe a case of subarachnoid hemorrhage due to a ruptured right vertebral artery (VA) aneurysm where endovascular therapy via a trans-femoral route was not feasible. Therefore we surgically exposed the VA and directly punctured it at the C4 level, followed by successful coil embolization. Direct access to the vertebral artery using an anterior surgical approach is an alternative in cases where the proximal side of the artery is occluded.

Recurrent Torticollis Caused by Dissecting Vertebral Artery Aneurysm in a Pediatric Patient: Results of Endovascular Treatment by Use of Coil Embolization: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (1) ◽  
pp. 204-208 ◽  
Author(s):  
Salvatore Grosso ◽  
Rosa Mostardini ◽  
Carlo Venturi ◽  
Sandra Bracco ◽  
Alfredo Casasco ◽  
...  
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Pediatric Patient ◽  
Coil Embolization ◽  
Artery Aneurysm

Isolated giant true intercostal artery aneurysm with arteriovenous fistula: A case report

Vascular ◽  
2021 ◽  
pp. 170853812110413
Author(s):  
Kenichi Honma ◽  
Terutoshi Yamaoka ◽  
Daisuke Matsuda
Keyword(s):  
Minimally Invasive ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Artery Aneurysm ◽  
Rare Condition ◽  
Intercostal Artery ◽  
Spinal Cord Infarction ◽  
Invasive Treatment ◽  
Intercostal Artery Aneurysm ◽  
The Right

Objectives Intercostal artery aneurysm (IAA) is a very rare condition. Interestingly, only one study reported a case of intercostal aneurysm caused by an arteriovenous fistula (AVF). Here, we report the case of a patient with non-ruptured isolated giant true IAA caused by an AVF (size, 28 × 41 mm). Methods Treatment options for IAA include open surgery and endovascular treatment (EVT). We chose EVT, as it is minimally invasive. The right 11th intercostal artery and aneurysm diverged from the aorta. Two outflow arteries, one inflow artery, and an AVF from the aneurysm were confirmed, and coil embolization was performed. The artery of Adamkiewicz did not communicate with the right 11th intercostal artery. We performed angiography and confirmed occlusion of IAA with endoleak. Results There were no clinical findings indicative of spinal cord infarction after treatment. The patient did not develop complications and was discharged the day after treatment. Endoleak was not observed on computed tomography angiography findings at 1 month after treatment. Conclusions In our patient, an AVF might have caused IAA. Endovascular treatment for non-ruptured isolated giant IAA is a safe and minimally-invasive treatment. We found that performing EVT is beneficial when the size of the IAA exceeds 30 mm.

scholarly journals Endovascular Coil Embolization of a Posterior Communicating Artery Aneurysm: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (6) ◽  
pp. E597-E598
Author(s):  
Maureen A Darwal ◽  
Zakaria Hakma ◽  
Mandy J Binning ◽  
Adam Arthur ◽  
Bain Mark ◽  
...  
Keyword(s):  
New York ◽  
Endovascular Treatment ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Posterior Communicating Artery ◽  
International Subarachnoid Aneurysm Trial ◽  
Endovascular Coil Embolization ◽  
Posterior Communicating Artery Aneurysm ◽  
Set Up

Abstract Since the International Subarachnoid Aneurysm Trial,1 endovascular treatment has been the favored treatment for appropriate ruptured intracranial aneurysms. While our endovascular technology has advanced to allow us to treat the majority of intracranial aneurysms, simple coil embolization is still the most common modality. This video demonstrates the fundamentals of aneurysm catheterization and coiling for safe treatment. In addition, the set-up and devices are detailed. This video is to add to the library of basic techniques that will aid a large number of practitioners. This patient consented to endovascular treatment. The video demonstrates endovascular coil embolization of a posterior communicating artery aneurysm in a 76-yr-old female who presented with a subarachnoid hemorrhage. Image of biplane suite in video used courtesy of Siemens Medical Solutions USA, Inc. Illustration at 5:12 reprinted from Yasargil MG, et al, Microneurosurgery IV B, p. 9, Thieme, New York, 1995.

scholarly journals Treatment Challenges of a Primary Vertebral Artery Aneurysm Causing Recurrent Ischemic Strokes

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Davide Strambo ◽  
Luca Peruzzotti-Jametti ◽  
Aurora Semerano ◽  
Giovanna Fanelli ◽  
Franco Simionato ◽  
...  
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Color Doppler ◽  
Artery Aneurysm ◽  
Neurofibromatosis Type ◽  
Distal Portion ◽  
Embolic Stroke ◽  
Left Vertebral Artery ◽  
Stroke Recurrence ◽  
Extracranial Vertebral Artery

Background. Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; surgical and endovascular therapy options are debated and long-term complication may occur. Case Report. A 53-year-old man affected by neurofibromatosis type 1 (NF1) came to our attention for recurrent vertebrobasilar embolic strokes, caused by a primary giant, partially thrombosed, fusiform aneurysm of the left extracranial vertebral artery. The aneurysm was treated by endovascular approach through deposition of Guglielmi Detachable Coils in the proximal segment of the left vertebral artery. Six years later the patient presented stroke recurrence. Cerebral angiography and Color Doppler Ultrasound well characterized the unique hemodynamic condition developed over the years responsible for the new embolic event: the aneurysm had been revascularized from its distal portion by reverse blood flow coming from the patent vertebrobasilar axis. A biphasic Doppler signal in the left vertebral artery revealed a peculiar behavior of the blood flow, alternately directed to the aneurysm and backwards to the basilar artery. Surgical ligation of the distal left vertebral artery and excision of the aneurysm were thus performed. Conclusion. This is the first described case of NF1-associated extracranial vertebral artery aneurysm presenting with recurrent embolic stroke. Complete exclusion of the aneurysm from the blood circulation is advisable to achieve full resolution of the embolic source.

scholarly journals Direct Vertebral Artery Access for the Endovascular Treatment of Basilar Artery Aneurysms

2012 ◽  
Vol 18 (1) ◽  
pp. 29-32 ◽  
Author(s):  
J.R. Vanzin ◽  
L. Bambini Manzato ◽  
F. Slaviero ◽  
M. Strzelecki ◽  
R. D'Agostini Annes
Keyword(s):  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Basilar Artery ◽  
Intracranial Aneurysms ◽  
Artery Aneurysm ◽  
Cervical Region ◽  
Alternative Route ◽  
Femoral Approach ◽  
Basilar Artery Aneurysm ◽  
Access Technique

The femoral approach has been considered the preferred technique for the endovascular treatment of intracranial aneurysms. Occasionally, aneurysms are not amenable to the standard femoral approach. We describe four cases of basilar artery aneurysm that were treated by the direct vertebral artery access of V1 at the cervical region. The direct vertebral artery access technique can provide an alternative route in selected cases for the treatment of basilar artery aneurysms.

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