Abstract
Giant fusiform aneurysm of the vertebral artery is not common and is usually associated
with thrombosis due to swirling blood flow, and manifests as mass effect on the medullary
region with slow progression of neurological sign and symptoms. Trapping and ligation
combined with bypass surgery, endovascular surgery, and proximal occlusion and flow
diverter placement have been described; however, the optimal treatment is still debatable.
A 35-year-old female presented to us with complaints of mild occipital headache, moderate
pain over the right side of the nape region, numbness, and tingling sensation transferring
to the right upper shoulder for 1 month. Magnetic resonance imaging (MRI) of cervical
spine and brain revealed normal cervical spine. Brain MRI and digital subtraction
angiography were done that revealed an almost completely thrombosed giant fusiform
aneurysm of the V4 segment of the vertebral artery. Patient underwent endovascular
therapy with complete coils packing. Postoperative status went uneventful. She was
discharged on the 7th day of procedure. Complete occlusion of thrombosed giant fusiform
V4 segment vertebral artery aneurysm by endovascular therapy with coils embolization
is safe and effective.
Keywords
thrombosed - giant fusiform aneurysm - vertebral artery - coils embolization - outcome
