Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia: Case report

Craig H. Rabb, Stanley L. Barnwell

    Research output: Contribution to journalArticlepeer-review

    25 Scopus citations

    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.

    Original languageEnglish (US)
    Pages (from-to)379-382
    Number of pages4
    JournalNeurosurgery
    Volume42
    Issue number2
    DOIs
    StatePublished - Feb 1998

    Keywords

    • Anticoagulation
    • Hemorrhage
    • Vertebrobasilar dolichoectasia

    ASJC Scopus subject areas

    • Surgery
    • Clinical Neurology

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