Basilar Artery Trunk Aneurysm: Concomitant Retroperitoneal and Subarachnoid Hemorrhage, Segmental Arterial Mediolysis (SAM), Dissecting Aneurysm, Treatment by Partial Coil Occlusion and Flow Diversion

  • Victoria HellsternEmail author
  • Marta Aguilar Pérez
  • Patricia Kohlhof-Meinecke
  • Hansjörg Bäzner
  • Oliver Ganslandt
  • Hans Henkes
Living reference work entry


“Segmental mediolytic arteriopathy” or “segmental arterial mediolysis” (SAM) is an idiopathic disorder of visceral and intracranial arteries and known as a cause of major abdominal, retroperitoneal, and subarachnoid hemorrhage (SAH). The affected arteries show a non-inflammatory and non-atherosclerotic vacuolization and lysis of the tunica media, smooth muscle degeneration, and serration of the lamina elastica interna, undermining the vessel wall stability. Spontaneous dissection and aneurysm formation followed by aneurysm rupture may occur. SAM is the most likely diagnosis in the case of simultaneous abdominal or retroperitoneal and subarachnoid hemorrhage. This is the case of a patient with simultaneously ruptured dissecting aneurysms of abdominal and intracranial arteries. The evolution and treatment of the dissecting basilar artery aneurysm by endovascular coil-assisted flow diversion is the main topic of this report.


Basilar artery trunk aneurysm Segmental arterial mediolysis SAH Dissecting aneurysm Partial coil occlusion Flow diversion 



This case report has been previously published with open access (Hellstern et al. 2017).


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Victoria Hellstern
    • 1
    Email author
  • Marta Aguilar Pérez
    • 1
  • Patricia Kohlhof-Meinecke
    • 2
  • Hansjörg Bäzner
    • 3
  • Oliver Ganslandt
    • 1
  • Hans Henkes
    • 1
  1. 1.Neuroradiologische Klinik, Neurozentrum, Klinikum StuttgartStuttgartGermany
  2. 2.Institut für Pathologie, Klinikum StuttgartStuttgartGermany
  3. 3.Neurologische Klinik, Neurozentrum, Klinikum StuttgartStuttgartGermany

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