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KMID : 0359719940120010126
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Journal of the Korean Neurological Association
1994 Volume.12 No. 1 p.126 ~ p.133
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Spontaneous Dissection Aneurysm of the Intracranial Portion of Vertebral Artery
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김상윤
강경수/이병철/김성민/송홍기/오세문/강익원
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Abstract
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Spontaneous dissection of the vertebrobasilar arterial system is less common than that of the carotid system. These dissection are usually found extracranially or in a combination of intracranial and extracranial location. Pure intracrainal
involvement
is uncommon. Particularly in oriental country, this vascular anomaly is one of the important causes of posterior circulation stroke in young and middle-aged adults. If manifested as brainstem, ischemia, the usual symptoms and signs are typically
neck or
occipital pain followed later by particular features of the lateral medullary syndrome. Etiology remains obscure in most cases of spontaneous dissection and management is still controversial.
We present three cases of dissecting aneurysm of the intracranial portion of unilateral vertebral artery. The two patients manifested as lateral medullary syndrome with sudden neck pain and digital substracted angiogram revealed proximal narrowed
segments and distal fusiform dilatation of the unilateral vertebral artery. The other patient manifested as subarachnoid hemmorrhage and angiographically dilatation at the junction of vertebral artery and posterior inferior cerebellar artery was
noted.
In operative field, two cases were confirmed as dissecting aneurysm.
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