科研之友
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摘要
a 26-year-old patient, on the 10th day of the puerperium, presented sudden pain in the left cervical region irradiated to the supraclavicular region on the same side, followed by the presence of a pulsatile mass. she reported a mean systolic hypertension of 160 mmhg, and mean diastolic hypertension of 130 mmhg in pregnancy and neurofibromatosis. at physical examination, she presented a pulsatile mass in the left supraclavicular region, without thrill and/or murmur. a widening of the mediastinum was detected by a thoracic x-ray. a computed tomography (cervical and thoracic region) showed a pulsatile mass in the territory of the left subclavian artery in its proximal portion, without having limits defined by contrast extravasation, besides a giant hemothorax on the left. the patient evolved with hypovolemic shock and was submitted to an urgent surgery, undergoing thoracotomy followed by cervicotomy, in which a ruptured aneurysmal lesion of the left vertebral artery was shown right after its emergency. after controlling the bleeding, a ligation was performed. the patient progressed satisfactorily, having an outpatient follow-up.
