OBJECTIVE: Treatment of bilateral vertebral artery dissecting @entity439 presenting with @entity510 remains challenging as bilateral deconstructive procedures may not be feasible. In this case series, we describe our approach to their management and review the pertinent literature. METHOD: A retrospective review of our prospectively collected database on @entity439 was performed to identify all @entity1 with acute @entity510 in the setting of bilateral intradural @entity4066 ( @entity4066 ) encompassing a period from January 2000 and March 2012. RESULT: Four @entity1 (M/F   =   2/2; mean age, 51.5 years) were identified. In two cases the site of @entity397 could be identified by angiographic and cross-sectional features; in these @entity1 deconstructive treatment (proximal obliteration or trapping) of the ruptured site and reconstructive treatment of the unruptured site (using stents and coils) were performed. In the @entity1 in whom the site of @entity548 could not be determined, bilateral reconstructive treatment was performed. No treatment-related complications were encountered. Modified Rankin scale scores were 0-1 at discharge, and on follow-up (mean 63 months), no recurrence, in-stent @entity715 or new @entity51 were encountered. CONCLUSION: We believe that single-stage treatment in @entity1 with bilateral @entity4066 is indicated: If the site of @entity548 can be determined, we prefer deconstructive treatment on the affected site and reconstructive treatment on the non-affected site to prevent increased hemodynamic stress on the unruptured but diseased wall. If the site of dissection cannot be determined, we prefer bilateral reconstructive treatment to avoid increasing hemodynamic stress on the potentially untreated acute hemorrhagic dissection.

Single-stage endovascular treatment of @entity510 related to bilateral vertebral artery dissecting XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhage'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid hemorrhage'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficits'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms'] @entity397 :: ('MESH:D012421', 'Disease') :: ['rupture'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity4066 :: ('MESH:D020217', 'Disease') :: ['vertebral artery dissections', 'VAD']
@entity439 :: (MESH:D000783,Disease) :: ['aneurysms']
