Traction-induced rupture of an extracranial vertebral artery aneurysm associated with neurofibromatosis - A case report

Study Design. This report describes presumed traction-induced rupture of a Vertebral artery aneurysm in a patient with neurofibromatosis Type I. Objective. To draw attention to the need for preoperative arteriography in the surgical management of severe cervical kyphosis in neurofibromatosis. Summary of Background Data. Aneurysmal dilatation is a rare but well-documented manifestation of neurofibromatosis. The complication of rupture of a vertebral artery lesion has not been described previously. Methods. The clinical features of the reported complication in a 56-year-old woman are detailed. Results. A successful outcome was achieved by embolization and later anterior and posterior spinal fusions. Conclusions. Vertebral arteriography should be part of the preoperative assessment of neurofibromatotic cervical kyphosis. Skull traction may produce aneurysmal rupture.