Katsumi Suzukawa’s research while affiliated with Chiba Kaihin Municipal Hospital and other places

A 37-year-old man presented with perimesencephalic non-aneurysmal subarachnoid hemorrhage associated with cavernous sinus thrombosis. Anticoagulant therapy was administered to treat the cavernous sinus thrombosis, but provoked severe intracranial hemorrhage, severely disabling the patient. Perimesencephalic non-aneurysmal subarachnoid hemorrhage is a benign clinical entity with generally good prognosis, but the association with cavernous sinus thrombosis requires careful investigation prior to treatment.

Subclavian artery aneurysm is relatively rare, but, we can scarcely find mention in the literature of a subclavian-vertebral junction aneurysm. We report a case of a 73-year-old man with a left subclavian-vertebral junction arterial aneurysm of 11 mm in diameter which caused a brain stem thromboembolism. He showed right hemiparesis and dysarthria on admission. On the 5th day after admission, his hemiparesis worsened and he could not even walk. In order to prevent further embolic attack on the vertebro-basilar system and rupture from the aneurysm, we embolized the aneurysm successfully with some GDC coils. During the operation, no further brain infarction occurred, and we maintained blood circulation in the left subclavian-vertebral artery. This aneurysm appeared on angiography to be atherosclerotic in its clinical characteristics, and we have scheduled follow-up angiography in two years time. As his hemiparesis had improved, he was discharged from the hospital on foot.