Intracranial vertebral artery dissection presenting as subarachnoid hemorrhage: successful endovascular treatment

INTRODUCTION: Intracranial vertebral artery dissection is a rare condition which may present as subarachnoid hemorrhage. In this situation, treatment is controversial. CASE REPORT: A case of intracranial right vertebral artery dissection in a 55-year-old woman presenting with subarachnoid hemorrhage is reported. The patient underwent therapeutic occlusion of the dissected artery through microcatheterization using pushing detachable platinum microcoils and had a good outcome. At this moment, the patient has a normal neurologic examination and a control digital subtraction angiography 1 year after the procedure showed an occluded right vertebral artery at V3; there was retrograde flow in the right intracranial vertebral artery up to the origin of a meningeal branch; the artery was thin and had mural irregularities, without any evidence of aneurismatic dilatation. DISCUSSION: We review the literature and discuss the role of endovascular therapy and other therapeutic options in the treatment of this condition.