A Case of Lateral Medullary Infarction after Endovascular Trapping of the Vertebral Artery Dissecting Aneurysm.
10.3340/jkns.2012.51.3.160
- Author:
In Yong CHO
1
;
Sung Kyun HWANG
Author Information
1. Department of Neurosurgery, College of Medicine, Ewha Womans University, Seoul, Korea. nshsg@ewha.ac.kr
- Publication Type:Case Report
- Keywords:
Vertebral artery;
Dissection;
Lateral medullary infarction
- MeSH:
Aneurysm;
Aneurysm, Dissecting;
Arteries;
Cerebral Angiography;
Deglutition Disorders;
Headache;
Humans;
Hydrocephalus;
Infarction;
Magnetic Resonance Spectroscopy;
Middle Aged;
Pica;
Risk Factors;
Subarachnoid Hemorrhage;
Ventriculoperitoneal Shunt;
Vertebral Artery
- From:Journal of Korean Neurosurgical Society
2012;51(3):160-163
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report an unusual case of lateral medullary infarction after successful embolization of the vertebral artery dissecting aneurysm (VADA). A 49-year-old man who had no noteworthy previous medical history was admitted to our hospital with a severe headache. Computed tomography (CT) revealed a subarachnoid hemorrhage, located in the basal cistern and posterior fossa. Cerebral angiography showed a VADA, that did not involve the origin of the posterior inferior cerebellar artery (PICA). We treated this aneurysm via endovascular trapping of the vertebral artery distal to the PICA. After operation, CT revealed post-hemorrhagic hydrocephalus, which we resolved with a permanent ventriculoperitoneal shunt procedure. Postoperatively, the patient experienced transient mild hoarsness and dysphagia. Magnetic resonance image (MRI) showed a small infarction in the right side of the medulla. The patient recovered well, though he still had some residual symptom of dysphagia at discharge. Such an event is uncommon but can be a major clinical concern. Further investigation to reveal risk factors and/or causative mechanisms for the medullary infarction after successful endovascular trapping of the VADA are sorely needed, to minimize such a complication.
