Medical and Interventional Therapy for Spontaneous Vertebral Artery Dissection in the Craniocervical Segment

Figure 1

MRI ((a) and (b)) showed multiple infarcts in the bilateral cerebellum especially in the right cerebellar hemisphere. Frontal and lateral DSA ((c) and (d)) of left VA angiogram showed the dissection in the segment of V3. Stenosis was the major appearance. Although the left VA was the nondominant one, the embolus is easy to escape and enter into both the right and left AICA (more into the right one) due to neck motion and the characteristics of anatomy of right AICA (the VA distal to the dissection, inferior segment of BA, and the initial segment of right AICA are almost in a line). Frontal and lateral DSA showed the stenosis disappeared after stenting ((e) and (f)). 2-dimensional and 3-dimensional DSA ((g) and (h)) showed the anatomical healing of the involved VA when following up. MRI: magnetic resonance image; DSA: digital subtraction angiography; VA: vertebral artery; AICA: anterior inferior cerebellar artery; BA: basilar artery.

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