gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Interdisciplinary management of patients presenting with subarachnoid hemorrhage due to vertebral artery dissecting aneurysms.

Meeting Abstract

  • P. Schuss - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • J. Konczalla - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • J. Berkefeld - Institut für Neuroradiologie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • H. Vatter - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • E. Güresir - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 062

DOI: 10.3205/12dgnc449, URN: urn:nbn:de:0183-12dgnc4490

Published: June 4, 2012

© 2012 Schuss et al.
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Outline

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Objective: The management and treatment of vertebral artery dissecting aneurysms is controversially discussed. We therefore analyzed our prospectively conducted neurovascular database concerning clinical characteristics, treatment modalities and functional outcome of patients suffering from SAH due to vertebral artery dissecting aneurysms.

Methods: From June 1999 to June 2011, 12 patients with spontaneous vertebral artery dissection were treated in our institution. Clinical and radiological characteristics were entered into a prospectively conducted database. Outcome was assessed according to the modified Rankin Scale (mRS) at 6 months.

Results: 8 patients (67%) were treated by a destructive technique by using proximal occlusion of the parent artery, whereas 4 patients (33%) were treated by a reconstructive technique using endovascular treatment modalities with preservation of the parent artery or complex vessel reconstruction by surgical clipping. Mean age was 56±6.1 years. Patients were in a poor neurological state at admission (mean Hunt & Hess grade 4.5±0.9). Favourable outcome (mRS 0–2) was achieved in 8 patients (67%).

Conclusions: We provide detailed data on interdisciplinary management of patients presenting with SAH caused by vertebral dissecting aneurysms. Despite poor-grade clinical status at admission, favourable outcome was achieved in a considerable number of patients.