VESSEL ARTERY DISSECTION AND PSEUDOANEURYSMS: ENDOVASCULAR APPROACHES

Robert A. Willinsky

doi:10.1055/s-2000-11558

Seminars in Neurosurgery, Table of Contents

Seminars in Neurosurgery 2000; 11(1): 59-70
DOI: 10.1055/s-2000-11558

VESSEL ARTERY DISSECTION AND PSEUDOANEURYSMS: ENDOVASCULAR APPROACHES

Robert A. Willinsky

Medical Imaging and Surgery, The University of Toronto, Neuroradiologist, The Toronto Western Hospital, University Health Network, Brain Vascular Malformation Study Group, Toronto, Ontario, Canada

Abstract

ABSTRACT

Intracranial dissections are frequently recognized as a cause of stroke and subarachnoid hemorrhage. The posterior circulation is the most common location for these dissections. The purpose of this article is to focus on the presentation and management of vertebral artery and posterior cerebral artery dissections. For patients presenting with stroke anticoagulation is the first line of treatment. For those presenting with a bleed proximal occlusion using endovascular techniques is the treatment of choice. Vertebral artery dissections (VADs) can be treated with either balloons or coils, and early angiographic follow-up is needed to reassess the status of the diseased segment. Trapping by endovascular techniques may be needed in a limited number of these VADs. Posterior cerebral artery dissections presenting with a bleed are best treated using Guglielmi detachable coils to achieve the shortest segment of occlusion.

KEYWORD

Dissecting aneurysm - vertebral artery - posterior cerebral artery - endovascular therapy

Full Text

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