Treatment of a Rare Case of Giant Vertebral Extracranial Aneurysm

Extracranial vertebral artery aneurysms are extremely rare and are usually associated with trauma or dissection. Primary extracranial vertebral artery aneurysms are far less common. They may be of mycotic origin or associated with systemic diseases (e.g., neurofibromatosis). The presentation and natural history remain idiopathic, and operative management can be often difficult. Angiography remains the criterion standard in diagnosis and characterization of these lesions. We hereby present a case of a primary aneurysm of the extracranial portion of the vertebral artery and its surgical management, which implied an initial endovascular approach followed by a 2-step surgery to resect the aneurysm and stabilize the spine.