Qj. Zhang et al., VERTEBROBASILAR JUNCTION FENESTRATION ASSOCIATED WITH DISSECTING ANEURYSM OF INTRACRANIAL VERTEBRAL ARTERY, Stroke, 25(6), 1994, pp. 1273-1275
Background Vertebrobasilar junction fenestration is considered to be a
subtype of fenestration of the proximal basilar artery, which has bee
n described only in autopsy cases. The fenestration associated with a
dissecting vertebral aneurysm is extremely rare. Case Description A 47
-year-old man presented with subarachnoid hemorrhage. The four-vessel
angiogram showed a fusiform dilatation with an intimal flap of the lef
t vertebral artery distal to the origin of the posterior inferior cere
bellar artery and a fenestration at the vertebrobasilar junction, in w
hich a small limb of the fenestration arising from the distal portion
of the left vertebral artery bridged the proximal basilar trunk, while
another limb had a large diameter showing the same diameter as the ba
silar artery. The dissecting aneurysm was treated with body clipping b
y directly clipping the ruptured portion of the aneurysm via a subocci
pital approach in an early operation 48 hours after the ictus. The pat
ient had a good recovery and returned to his work. He is well at a 5-y
ear follow-up. Conclusions The relevant angiographic features of the v
ertebrobasilar junction fenestration and the surgical treatment of suc
h associated aneurysms are discussed.