Treatment of Dissecting Vertebral Aneurysms

Twenty-seven cases of dissecting vertebral aneurysm were investigated in this study. These patients were divided into two groups consisting of an SAH group with 17 cases and a non-SAH group with cerebral ischemia and the like with 10 cases. In the SAH group, four patients had early onset of recurrence of bleeding. Of those four patients, two were inoperable and died. Surgery was performed on 14 patients. One patient died, but 13 patients had good recovery. Symptomatically the non-SAH group was diversified, with six cases of cerebral ischemia, two cases suffering only headaches and two cases that were discovered incidentally. Surgery was performed on three patients in whom aneurysmal dilation had been cofirmed on angiograms taken two weeks after onset. Postoperative courses were good with no exceptions. In other patients obstruction of the vertebral artery and string and pearl signs had subsided on the follow-up angiography. Surgical techniques comprised proximal clipping in 13 cases, trapping in three cases and coating in one case.