Vertebral artery dissecting aneurysm with subarachnoid hemorrhage treated by coil trapping: A case report

Vertebral artery dissection (VAD) is one of the most common causes of stroke, especially in young ages. It was found in 20% of ischemic strokes in young people and causes 2% of ischemic strokes. Dissecting intracranial pseudoaneurysm (IP) is a rare disorder that is associated with VAD that often leads to subarachnoid hemorrhage. We report a 43-year-old male presented with right vertebral artery dissection at the V4 segment and associated ruptured IP. The patient is treated with coil trapping at the dissected segment and maintained on nimodipine 60 mg/6 h and acetazolamide 250 mg bid. The patient was discharged with a slight improvement in muscle strength in the left and right arms. Endovascular treatment is considered the main interventional management of VAD. No established guidelines exist in the treatment of VAD. The choice of treatment is based on anatomical factors, clinical conditions, and potential risks and benefits associated with each treatment procedure.