Subarachnoid hemorrhage then thrombosis of posterior inferior cerebellar artery dissection: is early surgical exploration warranted?

J Neurointerv Surg. 2016 Jun;8(6):e22. doi: 10.1136/neurintsurg-2015-011740.rep. Epub 2015 May 18.

Abstract

The natural history of spontaneous cerebral artery dissection and thrombosis remains uncertain. Concurrent subarachnoid hemorrhage further complicates the therapeutic approach. Thus the best strategy for managing patients with acute vessel thrombosis in the setting of subarachnoid hemorrhage is unclear. Here we present a case of spontaneous posterior inferior cerebellar artery dissection presenting with subarachnoid hemorrhage and acute thrombosis. Although the patient was initially managed conservatively, angiographic follow-up demonstrated recanalization of the diseased vessel, necessitating definitive treatment. Thus we propose that angiographic follow-up is necessary in the management of patients with subarachnoid hemorrhage in association with apparent vessel thrombosis.

Keywords: Aneurysm; Angiography; Artery; Dissection; Hemorrhage.

MeSH terms

  • Arterial Occlusive Diseases / diagnostic imaging*
  • Arterial Occlusive Diseases / surgery
  • Cerebellum / blood supply*
  • Disease Progression
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery
  • Middle Aged
  • Recurrence
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Subarachnoid Hemorrhage / surgery
  • Thrombosis / diagnostic imaging*
  • Thrombosis / surgery
  • Ventriculoperitoneal Shunt
  • Vertebral Artery / diagnostic imaging*
  • Vertebral Artery / surgery
  • Vertebral Artery Dissection / diagnostic imaging*
  • Vertebral Artery Dissection / surgery