Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia

Case report

Craig H. Rabb, Stanley L. Barnwell

Research output: Contribution to journalArticle

24 Citations (Scopus)

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

Fingerprint

Vertebrobasilar Insufficiency
Subarachnoid Hemorrhage
Basilar Artery
Hemorrhage
Brain Stem
Rupture
Cranial Nerves
Natural History
Heparin
Autopsy
Thrombosis

Keywords

  • Anticoagulation
  • Hemorrhage
  • Vertebrobasilar dolichoectasia

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia : Case report. / Rabb, Craig H.; Barnwell, Stanley L.

In: Neurosurgery, Vol. 42, No. 2, 02.1998, p. 379-382.

Research output: Contribution to journalArticle

Rabb, Craig H. ; Barnwell, Stanley L. / Catastrophic subarachnoid hemorrhage resulting from ruptured vertebrobasilar dolichoectasia : Case report. In: Neurosurgery. 1998 ; Vol. 42, No. 2. pp. 379-382.
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