Abstract 3568: Natural History Of Dissecting Vertebral Artery Aneurysms
[Purpose]To evaluate the natural history of dissecting vertebral artery aneurysm without hemorrhage or ischemic stroke.
[Methods] Between October 2003 and June 2011, a total of 131 patients were diagnosed with vertebral artery dissecting aneurysm in our institution. Of these, 91 patients who were presented only pain or asymptomatic and they were observed with consecutive image studies. Clinical outcomes as well as image findings of these patients were retrospectively analyzed.
[Results] All 91 patients underwent consecutive image studies during the follow up period including MRI and / or 3D-CT angiography. No medical / surgical intervention was performed. Mean follow-up time period was 2.42 years. During the observation time, one patient (1.1%) developed an ischemic stroke (Wallenberg syndrome) followed by a subarachnoid hemorrhage (Hunt and Hess grade 2). 4 patients(4.4%) showed mild clinical worsening due to mass effect. Rest of 94.5% were clinically unchanged. Seventy two patients (79.1%) showed no change in the image findings during the observation time and 12 (13.2%) showed improvement. Enlargement of the aneurysm was seen in 5 patients (5.5%).
Of these.[Conclusion]With limited observation time in this study, vertebrobral artery dissecting aneurysms without stroke patients showed minimal hemorrhagic / ischemic event during the observation. For those who presented with asymptomatic or minute headache dissecting vertebral artery aneurysm, course observation with consecutive image studies may be a good management option unless they develop symptoms associated with significant mass effect.
- © 2012 by American Heart Association, Inc.