Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia: case report.

Abstract:

OBJECTIVE AND IMPORTANCE:Two patients with vertebrobasilar dolichoectasia sustained massive fatal subarachnoid hemorrhage from rupture of the basilar artery wall. Hemorrhage from this entity is not widely known to occur during its natural history and may be exacerbated by systemic anticoagulation. CLINICAL PRESENTATION:Two patients presented with ischemic events of the brain stem, which were attributed to vertebrobasilar dolichoectasia. The diagnosis was made on the basis of computed tomography and subsequent angiography. INTERVENTION:Both patients were treated with systemic anticoagulation with heparin and subsequently experienced massive fatal subarachnoid hemorrhage. Autopsy results confirmed the cause of hemorrhage to be frank rupture of the basilar artery wall. CONCLUSION:Vertebrobasilar dolichoectasia is a formidable structural entity afflicting the posterior circulation, which is generally thought to cause symptoms as a result of either compression of the adjacent brain stem and/or cranial nerves or ischemic events caused by thrombosis and perforator occlusion. Our experience with these two patients indicates that some lesions can hemorrhage, which is a factor that must be weighed when considering treatment alternatives.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Rabb CH,Barnwell SL

doi

10.1097/00006123-199802000-00108

subject

Has Abstract

pub_date

1998-02-01 00:00:00

pages

379-82

issue

2

eissn

0148-396X

issn

1524-4040

journal_volume

42

pub_type

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