A Case of a De Novo Vertebral Artery Dissecting Aneurysm after Trapping of the Contralateral Vertebral Artery Dissecting Aneurysm

A 49 year-old man presented with right hemifacial spasm and right facial neuralgia caused by a giant thrombosed fusiform dissecting aneurysm in the right vertebral artery. The ipsilateral posterior inferior cerebellar artery was not involved in the aneurysm. Endovascular internal trapping with coils was performed 9 hours before he lost his consciousness, and computed tomography showed subarachnoid hemorrhage mainly in the posterior fossa. Digital subtraction angiography revealed a de novo dissecting aneurysm in the contralateral vertebral artery. He died 3 days after the endovascular procedure for the right giant aneurysm because of repeated subarachnoid hemorrhage. Autopsy and pathological examinations showed a newly developed ruptured dissecting aneurysm in the contralateral vertebral artery. Ten cases of de novo vertebral artery dissecting aneurysms after trapping or occlusion of a dissecting aneurysm in the contralateral vertebral artery have been reported previously. We report our case and review of 11 reported cases, including ours.