Conclusion and
result
Following the procedure, the patient was received in a vitally stable
condition in the recovery room, where he was initially drowsy but
arousable and later shifted to a special care unit for further
neurological monitoring. His drowsiness improved, and he was discharged
as planned.
Vertebral artery pseudoaneurysm and vertebro-sigmoid fistula formation
are exceptionally rare complications of retro-sigmoid craniotomy. The
patient’s positive early outcome highlights the critical importance of
timely diagnosis and intervention to prevent further neurological
deficits. Due to their rarity, these complications often lead to a
delayed diagnosis. Advanced imaging techniques, like CT angiography or
digital subtraction angiography, are crucial for finding and
characterizing these lesions because traditional postoperative imaging
may not always reveal such complex vascular problems. The successful
management of this case through endovascular intervention with a covered
stent exemplifies the effectiveness of contemporary neuroradiological
techniques in maintaining vascular integrity and managing
life-threatening conditions. It also emphasizes how crucial it is to
closely monitor and follow up after neurosurgery, since early
identification of complications can have a significant impact on the
course of treatment. The short-term results of the reported case are
satisfactory. However, long-term follow-up data to determine prognosis
are still needed.