EXTRACRANIAL VERTEBRAL ARTERY PSEUDOANEURYSM PRESENTING AS SUBARACHNOID HEMORRHAGE

Background and Purpose: True aneurysms of the extracranial vertebral a rtery are rare. The usual pathogenesis of aneurysms in this location i s either penetrating or blunt trauma with resultant pseudoaneurysm for mation. We report a postpartum patient with a presumed traumatic pseud oaneurysm of the extracranial vertebral artery presenting with subarac hnoid hemorrhage. Case Description: A 41-year-old woman had three epis odes of neck stiffness 1 month after an uncomplicated vaginal delivery . The last episode, 3 days before admission, was accompanied by intens e neck and head pain and paresthesias that extended into the left arm, thumb, and forefinger. Results: Lumbar puncture showed subarachnoid h emorrhage. Angiography revealed a left vertebral artery dissection fro m C6-7 to C3 with pseudoaneurysm at C5-6. Computed tomography demonstr ated impingement of the C6 root at the foramen by this lesion. The les ion was successfully treated by balloon occlusion of the vertebral art ery. Conclusions: We present a patient with an extracranial vertebral pseudoaneurysm with subarachnoid hemorrhage and cervical root impingem ent. To our knowledge, this is the first case of such a lesion present ing as subarachnoid hemorrhage. The lesion was successfully treated us ing endovascular techniques.