Abstract
A 69-year-old female patient was transferred to our neuro-intensive care unit 35 h after a sudden collapse with a witnessed generalized epileptic seizure. Following the ictus, she was severely confused and developed oculomotor nerve palsy and hemiparesis (World Federation of Neurosurgical Societies (WFNS) grade IV), both on the left-hand side. Non-enhanced cranial CT (NCCT) revealed a large-volume subarachnoid hemorrhage (SAH) extending from the basal cisterns into both Sylvian fissures and the posterior fossa, with presence of hemorrhage layering in the third, fourth, and both occipital horns of the lateral ventricles. Computed tomography angiography (CTA) showed a lobular wide-necked aneurysm at the level of the left vertebral artery (VA/V4) segment. Complete obliteration of the ruptured aneurysm was achieved on the same day through coil occlusion, assisted by a Cascade Net (Perflow Medical). The application of the new temporary neck-bridging device Cascade Net is the main topic of this chapter.
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Sirakov, S., Sirakov, A., Henkes, H. (2020). Vertebral Artery Aneurysm: A Ruptured Wide-Necked Distal Vertebral Artery Aneurysm, Treated with Cascade Net-Assisted Coil Occlusion. In: Henkes, H., Lylyk, P., Ganslandt, O. (eds) The Aneurysm Casebook. Springer, Cham. https://doi.org/10.1007/978-3-319-77827-3_137
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