Extracranial Vertebral Artery Aneurysm Rupture Complicated by Extrapleural Haematoma

Extracranial vertebral artery aneurysm (EVAA) and extrapleural haematoma (EH) are rare clinical findings most often associated with blunt or penetrating trauma. However, EVAA rupture can be complicated by development of a large EH.

A 50 year old man underwent an emergency thrombectomy followed by graft reconstruction of an aorto-bi-femoral bypass. The post-operative course was complicated by respiratory failure and severe anaemia. Computed tomography revealed EVAA rupture and EH, so ligation of EVAA was performed with thoracotomy.

In a patient with extensive peripheral vascular disease and rapid development of EH, the rupture of a supra-aortic vessel aneurysm might be considered.