Endovascular treatment of intracranial vertebral artery dissecting aneurysm in a patient with aplastic anemia: A case report and literature review.

Intracranial vertebral artery dissecting aneurysm is a rare type of intracranial aneurysm characterized by outward protrusion of the vessel wall due to damage to the intima and elastic membrane. Aplastic anemia is a relatively rare and severe syndrome involving bone marrow failure leading to pancytopenia. No previously reported cases exist of intracranial vertebral artery dissecting aneurysm complicated by aplastic anemia. Due to thrombocytopenia and coagulation dysfunction, managing concomitant vascular lesions during neurointerventional therapy poses significant challenges. We report the case of a 40-year-old man who with a history of aplastic anemia. Computed tomography angiography revealed a dissecting aneurysm in the right vertebral artery segment IV, with a distal branch to the posterior inferior cerebellar artery. The patient demonstrated favorable outcomes following individualized neurointerventional surgery with no complications. This case underscores the importance of developing personalized neurointerventional strategies for patients with intracranial aneurysms complicated by hematologic disorders. Priority should be given to controlling bleeding risks while maintaining posterior circulation patency, providing crucial guidance for clinicians managing such conditions.