REVIEW article

Front. Neurol.

Sec. Endovascular and Interventional Neurology

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1566861

This article is part of the Research TopicAdvances in the Understanding, Diagnosis, and Management of Intracranial and Extracranial Arterial DissectionsView all 7 articles

Growth and Regression of an intracranial Vertebral Artery Dissecting Aneurysm

Provisionally accepted
Yalnaz MohasinYalnaz Mohasin1,2,3Timo KringsTimo Krings1,2,4*
  • 1Beth Israel Lahey Health, Boston MA, United States
  • 2Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
  • 3Royal College of Surgeons in Ireland (Bahrain), Al Muharraq, Bahrain
  • 4University of Massachusetts Medical School, Worcester, Massachusetts, United States

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Intracranial vertebral artery dissecting aneurysms (VADAs) are rare vascular abnormalities with diverse presentations and unpredictable natural histories. Traditionally considered aggressive lesions with high mortality, emerging evidence has suggested some unruptured cases may undergo stabilization or even regression. This report details a 47-year-old patient presenting with ataxia and neck pain following a presumed traumatic dissection, leading to a diagnosis of a right vertebral artery dissection with mural hematoma formation. Serial imaging over two-years demonstrated progressive aneurysmal growth with mass effect at 6 weeks and 9 weeks, followed by stabilization at 12 months and subsequent complete regression of the aneurysm by 24 months. Conservative management was pursued due to patient preference, highlighting the importance of patient selection in decision making for VADAs. The observed spontaneous regression likely reflects a combination of mural hematoma reabsorption, closure of the dissecting flap, and robust collateral circulation. This case contributes to the evolving understanding of intracranial dissection aneurysms, emphasizing the potential for self-healing in select cases while reinforcing the need for individualized treatment strategies.

Keywords: Vertebral Artery, Arterial dissection, Stroke, Hemorrhage, Spontaneous resolution

Received: 25 Jan 2025; Accepted: 18 Apr 2025.

Copyright: © 2025 Mohasin and Krings. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Timo Krings, Beth Israel Lahey Health, Boston MA, 02138, United States

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