THE diagnosis of arteriovenous aneurysm of the vertebral artery often goes unsuspected. This is probably due to the fact that it is a rare lesion attended with a high mortality rate and the anatomical location of the vessel makes it appear inaccessible.
The mode of presentation of these lesions is variable.1-6 There is commonly a history of trauma either by bullet wound or stabbing which in the latter instance usually involves the posterior or lateral aspect of the neck. Within weeks to months there usually appears an enlarging pulsatile mass in the cervical area which is obviously vascular in nature.1 Occasionally the trauma is not stressed and there is a slow progressive swelling in the neck without bruit or thrill; in these cases a tumor is often suspected.2 The largest single series of vertebral aneurysms3 is of ten cases, all secondary to war injuries. The most