Occult rupture of a giant vertebral artery aneurysm following proximal occlusion and intrasaccular thrombosis - Case report

The authors describe a unique clinicopathological phenomenon in a patient w ho presented with an unruptured giant vertebral artery aneurysm and who und erwent endovascular proximal occlusion of the parent artery followed, sever al days later, by surgical trapping of the aneurysm after delayed subarachn oid hemorrhage (SAH). The intraoperative finding of a thrombus extruding fr om the wall of the aneurysm at a site remote from the origin of the SAH und erscores the possibility that occult rupture of an aneurysmal sac can occur in patients with thrombosed giant aneurysms.