Skip to main content
Log in

Proximal clipping of dissecting intracranial vertebral aneurysm — effect of balloon Matas test with neurophysiological monitoring

Case report

  • Clinical Articles
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

A case of repeated subarachnoid haemorrhage (SAH) caused by rupture of a dissecting intracranial vertebral aneurysm is reported. The clinical manifestations, angiographic findings, pre-operative assessment with neurophysiological monitoring, and surgery are presented. A review of the literature suggests that this type of intracranial aneurysm is being recognized with increasing frequency in SAH and fatality, and therefore exploration and treatment of vertebrobasilar (V-B) dissecting aneurysms is necessary. We emphasize that a balloon Matas test with monitoring of somatosensory evoked potentials (SEP), auditory brain stem responses (ABR), and its wedge pressure in occluding the vertebral artery before operation are objective assessments of treatment for dissecting intracranial vertebral aneurysm.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adams Jr HP, Aschenbrenner CA, Kassell NFet al (1982) Intracranial hemorrhage produced by spontaneous dissecting intracranial aneurysm. Arch Neurol 39: 773–776

    PubMed  Google Scholar 

  2. Alexander CB, Burger PC, Goree JA (1979) Dissecting aneurysms of the basilar artery in 2 patients. Stroke 10: 294–299

    PubMed  Google Scholar 

  3. Berenstein A, Young W, Ransohoff Jet al (1984) Somatosensory evoked potentials during spinal angiography and therapeutic transvascular embolization. J Neurosurg 60: 777–785

    PubMed  Google Scholar 

  4. Berger MS, Wilson CB (1984) Intracranial dissecting aneurysms of the posterior circulation: Report of six cases and review of the literature. J Neurosurg 61: 882–894

    PubMed  Google Scholar 

  5. Crompton MR (1965) Subtentorial changes following the rupture of cerebral aneurysms. Brain 88: 75–84

    PubMed  Google Scholar 

  6. Ehrenfeld WK, Wylie EJ (1976) Spontaneous dissecting of the internal carotid artery. Arch Surg 111: 1294–1301

    PubMed  Google Scholar 

  7. Friedman AH, Drake CG (1984) Subarachnoid hemorrhage from intracranial dissecting aneurysm. J Neurosurg 60: 325–334, 1984

    PubMed  Google Scholar 

  8. Gherardi GJ, Lee HY (1967) Localized dissecting hemorrhage and arteritis. Renal and cerebral manifestations. JAMA 199: 219–220

    PubMed  Google Scholar 

  9. Grosman H, Fornasier VL, Bonder Det al (1980) Dissecting aneurysm of the cerebral arteries. Case report. J Neurosurg 53: 693–697

    PubMed  Google Scholar 

  10. Hugenholtz H, Pokrupa R, Montpetit VJAet al (1982) Spontaneous dissecting aneurysm of the extracranial vertebral artery. Neurosurgery 10: 96–100

    PubMed  Google Scholar 

  11. Hunter J (1839) The Works of John Hunter. JF Palmer (ed), vol 3. Longman, Rees, Orme, Brown, Green, and Longman, London, pp 594–612

    Google Scholar 

  12. Ito Y, Ishii R, Suzuki Yet al (1988) Ruptured dissecting aneurysm of the vertebral artery, revealed by repeat angiography. Neurosurgery 23: 225–227

    PubMed  Google Scholar 

  13. Kidooda M, Nakatu Y, Watanabe Ket al (1987) Monitoring of somatosensory evoked potentials during aneurysm surgery. Surg Neurol 27: 69–76

    PubMed  Google Scholar 

  14. Kulla L, Deymeer F, Smith TWet al (1982) Intracranial dissecting and saccular aneurysms in polycystic kidney disease. Report of a case. Arch Neurol 39: 776–778

    PubMed  Google Scholar 

  15. Kunze S, Schiefer W (1971) Angiographic demonstration of a dissecting aneurysm of the middle cerebral artery. Neuroradiology 2: 201–206

    PubMed  Google Scholar 

  16. Miyazaki S, Yamaura A, Kamata Ket al (1984) A dissecting aneurysm of the vertebral artery. Surg Neurol 21: 171–174

    PubMed  Google Scholar 

  17. Nelson JW (1968) Dissecting subintimal haematomas of the intracranial arteries: report of a case. J Am Osteopath Assoc 67: 512–527

    PubMed  Google Scholar 

  18. O'Dwyer JA, Moscow N, Trevor Ret al (1980) Spontaneous dissection of the carotid artery. Radiology 137: 379–385

    PubMed  Google Scholar 

  19. Pessin MS, Chimowitz MI, Levine SRet al (1989) Stroke in patients with fusiform vertebrobasilar aneurysms. Neurology (United States) 39(1), 16–21

    Google Scholar 

  20. Poppen JL (1951) Specific treatment of intracranial aneurysms. Experiences with 143 surgically treated patients. J Neurosurg 8: 75–102

    PubMed  Google Scholar 

  21. Ramsey TL, Mosqiera VT (1948) Dissecting aneurysm of the middle cerebral artery. Ohio State Med J 44: 168–170

    Google Scholar 

  22. Scholefield BG (1924) A case of aneurysm of the basilar artery. Guys Hosp Rep 74: 485–487

    Google Scholar 

  23. Sekino H, Nakayama N, Kato Yet al (1981) Dissecting aneurysms of the vertebro-basilar system: clinical and angiographic observation. No Shinkei Geka 9: 125–133

    PubMed  Google Scholar 

  24. Senter HJ, Sarwar M (1982) Nontraumatic dissecting aneurysm of the vertebral artery. Case report. J Neurosurg 56: 128–130

    PubMed  Google Scholar 

  25. Shimoji T, Bando K, Nakajima K, Ito K (1984) Dissecting aneurysm of the vertebral artery: Report of seven cases and angiographic findings. J Neurosurg 61: 1038–1046

    PubMed  Google Scholar 

  26. Symon L, Momma F, Schwerdtfeger Ket al (1986) Evoked potential monitoring neurosurgical practice. In: Symon Let al (eds) Advances and technical standards in neurosurgery, vol 14. Springer, Wien New York, pp 25–70

    Google Scholar 

  27. Turnbull HM (1915) Alterations in arterial structure, and their relation to syphilis. Q J Med 8: 201–254

    Google Scholar 

  28. Wang AD, Cone J, Symon Let al (1984) Somatosensory evoked potential monitoring during the management of aneurysmal SAH. J Neurosurg 60: 264–268

    PubMed  Google Scholar 

  29. Waga S, Fujimoto K, Morooka Y (1978) Dissecting aneurysm of the vertebral artery. Surg Neurol 10: 237–239

    PubMed  Google Scholar 

  30. Yamaura A, Makino H (1984) Long-term follow-up study of proximal clip occlusion and coating for fusiform aneurysms of the vertebral artery. Nou Sochuu No Geka Kenkyukai 13: 72–76

    Google Scholar 

  31. Yonas H, Agamanolis D, Takaoka Yet al (1977) Dissecting intracranial aneurysms. Surg Neurol 8: 407–415

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Su, C.C., Watanabe, T., Yoshimoto, T. et al. Proximal clipping of dissecting intracranial vertebral aneurysm — effect of balloon Matas test with neurophysiological monitoring. Acta neurochir 104, 59–63 (1990). https://doi.org/10.1007/BF01842895

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01842895

Keywords

Navigation