DISSECTION OF INTRACRANIAL VERTEBRAL ARTERIES REVEALED BY SUBARACHNOID HEMORRHAGE - REPORT OF 7 CASES

Between April 1986 and April 1991, seven cases of meningeal haemorrhag e consecutive to dissection of the 4th segment of a vertebral artery w ere observed at the Neuroradiology Department of the Nancy University Hospital. Four of the 7 patients were men, and 3 were women; mean age varied from 45 to 61 years. The clinical presentation was not suggesti ve, except in one case where the haemorrhagic episode was associated w ith Wallenberg's syndrome, pointing to the aetiological diagnosis. The outcome was variable. Two patients died of early complications of the haemorrhage which occurred before treatment could be given. In 2 othe rs patients treated with antiplatelet agents the outcome was favourabl e; however, at angiography the lesions regressed in one of these two p atients, but they progressed in the other with formation of a false an eurysm. The remaining 3 patients were treated by endovascular occlusio n of the lesion-bearing vessel: one died of complications of a haemorr hage-induced vasospasm; the other two are symptomless after a 2 to 6 m onths follow-up.