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Proximal vertebral artery occlusion was performed in eight patients with unclippable vertebral artery or vertebro-basilar junction aneurysms. The initial symptom was subarachnoid hemorrhage in 5 patients, symptoms due to a space-occupying lesion in 2 patients, and cerebral embolism in one patients. In two patients, serious complications were found after operations. A 61-year-old man had cerebral infarction in the area of the posterior cerebral artery and the posterior inferior cerebellar artery (PICA) after vertebral artery occlusion proximal to PICA for a fusiform vertebral aneurysm. A 55-year-old woman had brainstem infarction after operation for a giant vertebro-basilar junction aneurysm. Possible mechanisms of these complications are discussed in this paper.

Proximal Vertebral Artery Occlusion for Patients with Unclippable Vertebro-basilar Artery Aneurysms