scholarly journals Vertebral Artery Dissecting Aneurysm Causing Central Tapia’s Syndrome: A Case Report

2021 ◽  
Author(s):  
Yong Woo Shim ◽  
Jung Hyun Park ◽  
Sung-Tae Kim ◽  
Jin Wook Baek ◽  
Hyun Gon Lee ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Dissecting Aneurysm ◽  
Flow Diversion ◽  
Rare Presentation ◽  
Central Type ◽  
Tapia’S Syndrome ◽  
The Right ◽  
Vertebral Artery Dissecting Aneurysm

The central type of Tapia’s syndrome is an extremely rare presentation, characterized by unilateral paralysis of the vagal and hypoglossal nerves, contralateral hemiparesis, or hemihypesthesia. This report describes a case of a middle-aged patient who developed central Tapia’s syndrome due to a right vertebral artery dissecting aneurysm (VADA). The patient complained about swallowing difficulty and odynophagia. Right vocal cord paralysis, mild tongue deviation to the right side, left hypesthesia, and decreased temperature sensation with left hemiparesis were observed in neurologic exams. A right VADA and compression of the medulla oblongata due to the VADA were diagnosed on magnetic resonance imaging. Endovascular flow diversion of the right VADA was performed. After 1 year, all neurological symptoms and vocal cord paralysis were nearly resolved, but left hypesthesia remained with decreased nociception. We present and discuss how a VADA caused those symptoms and propose endovascular flow diversion as a treatment option.

scholarly journals Case Report: De novo Vertebral Artery Dissection After Intravascular Stenting of the Contralateral Unruptured Vertebral Artery Aneurysm

2021 ◽  
Vol 12 ◽  
Author(s):  
Wei You ◽  
Junqiang Feng ◽  
Qinglin Liu ◽  
Xinke Liu ◽  
Jian Lv ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
De Novo ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
Artery Dissection ◽  
Vertebrobasilar Artery ◽  
Fourth Segment ◽  
Stress Changes ◽  
The Right ◽  
Vertebral Artery Dissecting Aneurysm

Spontaneous vertebral artery dissecting aneurysm has been increasingly attributed as a major cause of focal neurological deficits due to vertebrobasilar artery ischemia or subarachnoid hemorrhage (SAH). Although the development of spontaneous vertebral artery dissecting aneurysm (VADA) is rare, de novo VADA after treatment of contralateral vertebral artery (VA) is more less frequently observed. There are only a few reports related to de novo VADA after treatment of the contralateral VA in the medical literature. The mechanisms responsible for de novo dissection after treatment of unilateral VADA are still not clearly understood. In this manuscript, we report an unusual case of a patient with a de novo VADA after placement of a pipeline embolization device (PED) stent on the contralateral VA along with a thorough review of the literature. A 42-years old male patient was referred to the hospital with sudden onset of dizziness, nausea, and vomiting. Initial digital subtraction angiography (DSA) images demonstrated a VADA in the fourth segment of the left VA without the involvement of the posterior inferior cerebellar artery (PICA). There were no significant abnormalities found in the right vertebral artery. He underwent an endovascular pipeline embolization to treat the dissecting aneurysm (DA). Surprisingly, follow-up DSA imaging 14 months after the initial treatment showed a segmental dilatation and narrowing of the right VA, which suggested a de novo VADA on the right side that had occurred postoperatively. This was followed by a tent-assisted coil embolization therapy for occluding this de novo VADA. This patient showed an uneventful postoperative course with no neurological abnormalities. In addition to hemodynamic stress changes, the unique clinicopathological features of dissecting aneurysms may contribute significantly to the pathogenesis of de novo VA dissection. Given that VA in VADA patients may be vulnerable on both sides, it is important to consider the risk of de novo dissection after initial aneurysm treatment. The bilateral vertebral artery has to be carefully observed when treating any VADA patient to prevent any complications.

scholarly journals Vertebral artery dissecting aneurysm treated by internal trapping via the contralateral vertebral artery: A case report

2015 ◽  
Vol 21 (5) ◽  
pp. 576-579 ◽  
Author(s):  
Atsuhiro Kojima
Keyword(s):  
Vertebral Artery ◽  
Sudden Onset ◽  
Dissecting Aneurysm ◽  
Left Vertebral Artery ◽  
Distal Side ◽  
Consciousness Disturbance ◽  
History Of ◽  
The Right ◽  
Vertebral Artery Dissecting Aneurysm ◽  
Guiding Catheter

A 42-year-old man with a history of sudden onset of severe headache followed by consciousness disturbance was brought to our hospital. Radiological examinations revealed subarachnoid hemorrhage, associated with rupture of a left vertebral artery dissecting aneurysm. Initially, internal trapping was attempted via the ipsilateral vertebral artery. However, the microcatheter could not be navigated through the true lumen to the distal side of the vertebral artery. Subsequently, therefore, the guiding catheter was placed in the right vertebral artery, and the microcatheter was retrogradely navigated successfully through the lesion to the proximal side of the left vertebral artery. Finally, the lesion was completely embolized with electrodetachable coils without complications. However, the patient died after the operation because of deterioration of the general condition. The postmortem examination revealed how an intimal flap had interfered with the antegrade navigation of the microcatheter in the lesion. The present case showed that endovascular treatment for a vertebral artery dissecting aneurysm via the contralateral vertebral artery may be a useful option in cases where antegrade navigation of the microcatheter via the ipsilateral vertebral artery is found to be difficult.

scholarly journals Vertebral Artery Dissecting Aneurysm With Cushing's Syndrome

2010 ◽  
Vol 50 (4) ◽  
pp. 313-315 ◽  
Author(s):  
Masayasu KATO ◽  
Yoshitaka TANAKA ◽  
Tatsuya KURODA ◽  
Toshihiko NAKASHIMA ◽  
Tatsuaki HATTORI
Keyword(s):  
Vertebral Artery ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
Dissecting Aneurysm ◽  
Vertebral Artery Dissecting Aneurysm

Neonatal Vocal Cord Paralysis Following Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 793-796 ◽  
Author(s):  
Robert E. Schumacher ◽  
Irvin J. Weinfeld ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Recurrent Laryngeal Nerve ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Vocal Cord Palsy ◽  
Laryngeal Nerve ◽  
Membrane Oxygenation ◽  
The Right ◽  
Unilateral Vocal Cord Paralysis

Five cases of unilateral vocal cord paralysis/ paresis were diagnosed following extracorporeal membrane oxygenation for newborn respiratory failure. All were right sided and transient in nature. None of the five patients had other findings commonly associated with vocal cord palsy. The extracorporeal membrane oxygenation procedure requires surgical dissection in the carotid sheath on the right side of the neck, an area immediately adjacent to both the vagus and recurrent laryngeal nerve. It is speculated that vocal cord paralysis in these infants was acquired as a result of the extracorporeal membrane oxygenation cannulation. Although the vocal cord paralysis resolved in all cases, two patients had difficult courses after extracorporeal membrane oxygenation. Therefore, laryngoscopic examination should be considered for patients after extracorporeal membrane oxygenation.

Clinical and radiological risk factors for rupture of vertebral artery dissecting aneurysm: significance of the stagnation sign

2021 ◽  
pp. 1-6
Keyword(s):  
Risk Factors ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Significant Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Significant Risk Factor ◽  
Tertiary Hospital ◽  
Dissecting Aneurysm ◽  
Irregular Surface ◽  
Vertebral Artery Dissecting Aneurysm

OBJECTIVE The aim of this study was to investigate the clinical and radiological factors associated with the rupture of a vertebral artery dissecting aneurysm (VADA) and to evaluate whether the stagnation sign is a significant risk factor for rupture of VADA. METHODS Clinical and radiological variables of 117 VADAs treated in a tertiary hospital from September 2008 to December 2020 were retrospectively reviewed. The stagnation sign is defined as the finding of contrast agent remaining in the lesion until the venous phase of angiography. Univariate and multivariate analyses were executed to reveal the associations between rupture status and VADA characteristics. RESULTS The rate of ruptured VADAs was 29.1% (34 of 117) and the stagnation sign was observed in 39.3% (46 of 117). Fusiform shape (OR 5.105, 95% CI 1.591–16.383, p = 0.006), irregular surface (OR 4.200, 95% CI 1.412–12.495, p = 0.010), posterior inferior cerebellar artery (PICA) involvement (OR 3.788, 95% CI 1.288–11.136, p = 0.016), and the stagnation sign (OR = 3.317, 95% CI 1.131–9.732, p = 0.029) were significantly related to rupture of VADA in multivariate logistic regression analysis. CONCLUSIONS This study showed that fusiform shape, irregular surface, PICA involvement, and the stagnation sign may be independent risk factors for the rupture of VADA. Therefore, when the potential risk factors are observed in unruptured VADA, more aggressive treatment rather than follow-up or medical therapy may be considered.

scholarly journals Proximal Flow Arrest With Temporary Subclavian Steal for Internal Trapping of a Ruptured Vertebral Artery Dissecting Aneurysm

2007 ◽  
Vol 47 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Takehiro UDA ◽  
Keiji MURATA ◽  
Kazuhito NAKAMURA ◽  
Tsutomu ICHINOSE ◽  
Taro KUSAKABE ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Dissecting Aneurysm ◽  
Subclavian Steal ◽  
Vertebral Artery Dissecting Aneurysm
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