Figure 12

25-year old woman involved in a rollover motor vehicle collision. On admission to the hospital, a screening four-vessel angiogram revealed a pseudoaneurysm of the left vertebral artery at the level of the C1–C2 disc space. Follow-up angiography performed 7 days later revealed enlargement of the pseudoaneurysm and concomitant narrowing of the vertebral artery. Due to the tortuosity of the vertebral artery, stent placement was not deemed a viable option and the vertebral artery was embolized. Post-embolization anteroposterior digital subtraction angiogram, right vertebral artery. There is normal filling of the basilar artery, and reflux of contrast into the distal left vertebral artery which fills the left posterior inferior cerebellar artery (arrow). Images courtesy of Guido Scatorchia, MD.