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Neurofibromatosis (NF1) is a relatively common multi-system genetic disorder. NF1 increases the risk of hypertension, and vasculopathy is a common finding. Extracranial vertebral artery aneurysm, though rare, can rupture and cause fatal hemorrhage. Pregnancy in NF1 is known to be associated with hypertension, preeclampsia, Hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. We report anesthesia management of a primigravida with 30 weeks of gestation with neurofibromatosis presenting with severe preeclampsia and acute onset vertebral artery aneurysm, who underwent urgent cesarean section. We opted for general anesthesia over regional due to the risk of aneurysm rupture and technical difficulty with vigilant hemodynamic control. Postoperative course was complicated with HELLP and sepsis but was successfully managed. Knowledge, careful preoperative evaluation, appropriate technique, and management of anesthesia, and close postoperative monitoring are of utmost importance. [ABSTRACT FROM AUTHOR]

Background and Aims: Extracranial vertebral artery aneurysms are a rare cause of embolic stroke; various surgical and endovascular treatment options are available. Methods: We report a 44-year-old man with a symptomatic proximal extracranial vertebral artery aneurysm of unclear etiology. The patient presented with brainstem infarction, and the diagnosis of primary extracranial vertebral artery aneurysm was made by computed tomography angiography (CTA). Results: This patient's aneurysm was definitively treated using an endovascular approach with placement of a covered stent in the right proximal vertebral artery. Conclusion: Although aneurysms of this location are traditionally repaired with open aneurysmectomy, we show that endovascular treatment can be a safe and effective alternative approach. In the case reported here, primary extracranial vertebral artery aneurysm presenting with embolic stroke was successfully treated with a covered stent. Complete exclusion of the aneurysm from blood circulation is advisable to achieve full resolution of the embolic source. [ABSTRACT FROM AUTHOR]

Vertebral artery compressing the medulla and causing intractable vomiting has only been reported once previously. We report a case of a 69-year-old woman with intractable nausea and vomiting causing a 50 pound weight loss and who failed medical management and whose symptoms were completely reversed following microvascular decompression (MVD). [ABSTRACT FROM AUTHOR]