Acute Endovascular Therapy for Iatrogenic Vertebral Artery Injury: A Case Report

Vertebral artery pseudoaneurysm: a rare cause of posterior circulation infarction in a middle-aged man

Pseudoaneurysm of the vertebral artery is a rare cause of posterior circulation stroke. Treatment for this condition can be achieved through microscopic surgery or endovascular therapy. We report a case of a 36-year-old middle-aged male patient who presented with left limb numbness as the sole complaint. On a magnetic resonance imaging examination, multiple infarcts were observed in the left cerebellar tonsil. A subsequent head and neck computed tomography angiography examination led to the diagnosis of a pseudoaneurysm in the left vertebral artery. Following standard antiplatelet therapy, the patient underwent endovascular intervention. The patient's left limb numbness gradually subsided after surgery. A follow-up angiography performed 1 week after discharge showed no recurrence. These findings suggest that covered stent placement is an effective method of treating pseudoaneurysm of the vertebral artery.

Multiple Myeloma Treatment Challenges: A Case Report of Vertebral Artery Pseudoaneurysm Complicating Occipitocervical Arthrodesis and a Review of the Literature

Multiple myeloma is a hematological neoplasm that frequently affects the spinal column. Less than a fifth of this vertebral involvement corresponds to the cervical spine and cranio-cervical junction. When there is instability or neurological involvement due to compression or deformity, approaches for anterior decompression and occipitocervical stabilization are required. The correct managment of vertebral artery aneurysm associated with occipitocervical arthrodesis requires extensive knowledge of anatomy and pathology. We present a case of a vertebral pseudoaneurysm that occurred late after the resection of a C1-C2 vertebral body multiple myeloma lesion managed with endonasal endoscopic approach and posterior occipitocervical arthrodesis as well as a systematic review of the related literature. The patient recovered well, without major neurological deficits.