Extradural vertebral artery dissecting aneurysm causing subarachnoid haemorrhage

The authors report the case of a 37-year-old man who presented with subarachnoid haemorrhage (SAH) after rupture of an extradural vertebral artery dissecting aneurysm. The patient underwent a left lateral suboccipital craniotomy with removal of the medial part of the occipital condyle and the fusiform dilatation was coated. The angiograms 3 months after surgery showed aneurysm resolution and normal vessel calibre. To the authors' knowledge, it is the second reported case of extracranial vertebral aneurysm of its kind presenting as SAH. The result after surgery in this case indicates that coating of a dissecting aneurysm of the extracranial portion of the vertebral artery (VA) is a valid alternative surgical technique for the prevention of rebleeding.