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Ng Puay Yong 대한뇌혈관외과학회 2022 Journal of Cerebrovascular and Endovascular Neuros Vol.24 No.1
Ruptured giant aneurysms in the posterior circulation with poor grade subarachnoid haemorrhage (SAH) are associated with poor outcome. In this report four patients with ruptured giant vertebral artery aneurysms who presented acutely with World Federation of Neurosurgical Societies (WFNS) grade five SAH are reviewed. All 4 cases required intubation and ventilation on arrival. Brainstem reflexes were intact in all of them. Early endovascular parent artery coil occlusion was done in two cases. Two other cases were treated with early surgical proximal parent artery clip occlusion. Two cases required ventriculoperitoneal shunting. All cases achieved good recovery with full functional independent outcome at two years follow up. MR angiogram at two years documented resolution of aneurysms. In conclusion good outcome may be possible in some cases of ruptured giant vertebral artery aneurysms with WFNS grade five SAH.