PMC10407084_01
Images of the patient upon admission. (A) Axial T2-weighted MR image shows a fusiform aneurysm as a flow void signal left of the pons. (B) Three-dimensional CT angiography shows VA fusiform aneurysm. VA, vertebral artery.
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F1
Magnetic resonance imaging revealed an aneurysm of the intracranial segment of the left vertebral artery, which was appressed to the left facial nerve (Figure 1).
(A) Cerebral angiography before and after endovascular treatment and preoperative cerebral angiogram shows a fusiform aneurysm at the V3 segment. (B, C) Angiograms after endovascular treatment show the complete occlusion of left VA, including aneurysm. VA, vertebral artery.
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F2
Cerebral angiography revealed an aneurysmal enlargement in the V3 segment of the left vertebral artery, with no obvious aneurysm neck and a maximum transverse diameter of 1.2 cm (Figure 2A). An Excelsior SL-10 microcatheter (Stryker, USA) was superselected through the ipsilateral vertebral artery under the guidance of a microguide wire into the aneurysm, and seven coils (MicroVention, USA) were used to fill the aneurysm completely (Figures 2B, C). 2 hours after the surgery, the sheath was removed, and the femoral artery puncture point was pressed for 15 min, the elastic bandage "8" word compression bandage could be used when there was no active bleeding, total bed rest, and the lower limb was immobilized for 12 h.
Monitoring of the lateral spread response during endovascular surgery. The LSR shows before embolization of the aneurysm (black arrow). The LSR disappears after intraoperative embolization of the aneurysm (red arrow).
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F3
After intraoperative embolization of the aneurysm, electrophysiological monitoring showed that LSR disappeared (Figure 3).