Growth and regression of an intracranial vertebral artery dissecting aneurysm
Intracranial vertebral artery dissecting aneurysms (VADAs) are rare vascular abnormalities with diverse presentations and unpredictable natural histories. Traditionally considered aggressive lesions with high mortality, emerging evidence has suggested some unruptured cases may undergo stabilization...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1566861/full |
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| author | Yalnaz Mohasin Yalnaz Mohasin Timo Krings Timo Krings Timo Krings |
| author_facet | Yalnaz Mohasin Yalnaz Mohasin Timo Krings Timo Krings Timo Krings |
| author_sort | Yalnaz Mohasin |
| collection | DOAJ |
| description | Intracranial vertebral artery dissecting aneurysms (VADAs) are rare vascular abnormalities with diverse presentations and unpredictable natural histories. Traditionally considered aggressive lesions with high mortality, emerging evidence has suggested some unruptured cases may undergo stabilization or even regression. This report details a 47-year-old patient presenting with ataxia and neck pain following a presumed traumatic dissection, leading to a diagnosis of a right vertebral artery dissection with mural hematoma formation. Serial imaging over two-years demonstrated progressive aneurysmal growth with mass effect at 6 weeks and 9 weeks, followed by stabilization at 12 months and subsequent complete regression of the aneurysm by 24 months. Conservative management was pursued due to patient preference, highlighting the importance of patient selection in decision making for VADAs. The observed spontaneous regression likely reflects a combination of mural hematoma reabsorption, closure of the dissecting flap, and robust collateral circulation. This case contributes to the evolving understanding of intracranial dissection aneurysms, emphasizing the potential for self-healing in select cases while reinforcing the need for individualized treatment strategies. |
| format | Article |
| id | doaj-art-e7201d91e64d4718830ef5a9ae49cdbe |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-e7201d91e64d4718830ef5a9ae49cdbe2025-08-20T03:11:26ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15668611566861Growth and regression of an intracranial vertebral artery dissecting aneurysmYalnaz Mohasin0Yalnaz Mohasin1Timo Krings2Timo Krings3Timo Krings4Royal College of Surgeons in Ireland, Al Muharraq, BahrainDivision of Neurointerventional Radiology, Lahey Hospital & Medical Center-Beth Israel Lahey Health, UMass Chan Medical School, Boston, MA, United StatesDivision of Neurointerventional Radiology, Lahey Hospital & Medical Center-Beth Israel Lahey Health, UMass Chan Medical School, Boston, MA, United StatesDepartment of Medical Imaging, University of Toronto, Toronto, ON, CanadaSingleton Department of Radiology, Texas Children’s Hospital and Baylor College of Medicine, Houston, TX, United StatesIntracranial vertebral artery dissecting aneurysms (VADAs) are rare vascular abnormalities with diverse presentations and unpredictable natural histories. Traditionally considered aggressive lesions with high mortality, emerging evidence has suggested some unruptured cases may undergo stabilization or even regression. This report details a 47-year-old patient presenting with ataxia and neck pain following a presumed traumatic dissection, leading to a diagnosis of a right vertebral artery dissection with mural hematoma formation. Serial imaging over two-years demonstrated progressive aneurysmal growth with mass effect at 6 weeks and 9 weeks, followed by stabilization at 12 months and subsequent complete regression of the aneurysm by 24 months. Conservative management was pursued due to patient preference, highlighting the importance of patient selection in decision making for VADAs. The observed spontaneous regression likely reflects a combination of mural hematoma reabsorption, closure of the dissecting flap, and robust collateral circulation. This case contributes to the evolving understanding of intracranial dissection aneurysms, emphasizing the potential for self-healing in select cases while reinforcing the need for individualized treatment strategies.https://www.frontiersin.org/articles/10.3389/fneur.2025.1566861/fullvertebral arteryarterial dissectionstrokehemorrhagespontaneous resolution |
| spellingShingle | Yalnaz Mohasin Yalnaz Mohasin Timo Krings Timo Krings Timo Krings Growth and regression of an intracranial vertebral artery dissecting aneurysm Frontiers in Neurology vertebral artery arterial dissection stroke hemorrhage spontaneous resolution |
| title | Growth and regression of an intracranial vertebral artery dissecting aneurysm |
| title_full | Growth and regression of an intracranial vertebral artery dissecting aneurysm |
| title_fullStr | Growth and regression of an intracranial vertebral artery dissecting aneurysm |
| title_full_unstemmed | Growth and regression of an intracranial vertebral artery dissecting aneurysm |
| title_short | Growth and regression of an intracranial vertebral artery dissecting aneurysm |
| title_sort | growth and regression of an intracranial vertebral artery dissecting aneurysm |
| topic | vertebral artery arterial dissection stroke hemorrhage spontaneous resolution |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1566861/full |
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