scholarly journals Isolated left vertebral artery terminating in the posterior inferior cerebellar artery in South African patients: Two case studies

2021 ◽  
pp. 100157
Author(s):  
Bukola R. Omotoso ◽  
Rohen Harrichandparsad ◽  
Indheresan G. Moodley ◽  
Kapil S. Satyapal ◽  
Lelika Lazarus
2019 ◽  
Vol 12 (8) ◽  
pp. e231335 ◽  
Author(s):  
Sean Thomas O’Reilly ◽  
Ian Rennie ◽  
Jim McIlmoyle ◽  
Graham Smyth

A patient in his mid-40s presented with acute basilar artery thrombosis 7 hours postsymptom onset. Initial attempts to perform mechanical thrombectomy (MT) via the femoral and radial arterial approaches were unsuccessful as the left vertebral artery (VA) was occluded at its origin and the right VA terminated in the posterior inferior cerebellar artery territory, without contribution to the basilar system. MT was thus performed following ultrasound-guided direct arterial puncture of the left VA in its V3 segment, with antegrade advancement of a 4 French radial access sheath. First pass thrombolyisis in cerebral infarction (TICI) 3 recanalisation achieved with a 6 mm Solitaire stent retriever and concurrent aspiration on the 4 French sheath. Vertebral closure achieved with manual compression.


1994 ◽  
Vol 81 (2) ◽  
pp. 304-307 ◽  
Author(s):  
Mazen H. Khayata ◽  
Robert F. Spetzler ◽  
Jan J. A. Mooy ◽  
James M. Herman ◽  
Harold L. Rekate

✓ The case is presented of a 5-year-old child who suffered a subarachnoid hemorrhage from a giant left vertebral artery-posterior inferior cerebellar artery (PICA) aneurysm. Initial treatment consisted of surgical occlusion of the parent vertebral artery combined with a PICA-to-PICA bypass. Because of persistent filling of the aneurysm, the left PICA was occluded at its takeoff from the aneurysm. Endovascular coil occlusion of the aneurysm and the distal left vertebral artery enabled complete elimination of the aneurysm. Follow-up magnetic resonance imaging and arteriography performed 6 months postoperatively showed persistent occlusion and elimination of the mass effect. Combined surgical bypass and endovascular occlusion of the parent artery may be a useful adjunct in the management of these aneurysms.


2015 ◽  
Vol 12 (2) ◽  
pp. 163-167
Author(s):  
Khaled Effendi ◽  
Elsa Magro ◽  
Jean-Christophe Gentric ◽  
Tim E Darsaut ◽  
Jean Raymond ◽  
...  

Abstract BACKGROUND The ascending pharyngeal artery (APA) may, in very rare cases, supply the posterior inferior cerebellar artery (PICA). In reported cases, when such is the case, the ipsilateral vertebral artery (VA) does not supply the PICA, and most of the time it is hypoplastic. OBJECTIVE To describe a unique cadaveric observation of a direct anastomosis between the posterior division (neuromeningeal) of the jugular branch of the APA and the PICA, where the PICA is also supplied by a normal-size VA. METHODS A direct connection between the APA and the PICA was examined in a cadaveric specimen using a 3-dimensional endoscope and a surgical microscope. RESULTS The enlarged jugular branch of the posterior division of the APA entered intracranially via the jugular foramen in its pars vascularis. It then connected directly with the lateral medullary segment of the PICA. The first segment of the PICA originated from a left vertebral artery of normal size and continued its normal course beyond the junction with the jugular branch of the APA. CONCLUSION Both the VA and the jugular branch of the APA may simultaneously supply the PICA territory. Recognition of this anatomic variant is relevant when planning surgical or endovascular treatments.


2015 ◽  
Vol 22 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Yasuhiro Kawabata ◽  
Tetsuya Tsukahara ◽  
Shunichi Fukuda ◽  
Satoru Kawarazaki ◽  
Tomokazu Aoki

Background Double origin of the posterior inferior cerebellar artery (DOPICA) has been rarely reported in the literature, with a reported incidence of 1.45%. In contrast, a high concurrence rate of DOPICA and vertebral artery dissecting aneurysm has been reported. Clinical presentation A 61-year old woman presented with vomiting and diplopia with preceding headache. Magnetic resonance imaging (MRI) showed fresh infarction of the left lateral medulla and a vertebral artery dissecting aneurysm of the left vertebral artery. The next day, she exhibited transient loss of consciousness and worsening of headache, and MRI depicted subarachnoid hemorrhage. Four-vessel digital subtraction angiography showed a posterior inferior cerebellar artery (PICA) arising both intracranially and extracranially from the left vertebral artery. Although the dissecting lesion involved the V3 and V4 portion, it did not involve an extracranially originating PICA. Internal trapping of the V3 and V4 portion was chosen as the extracranial channel was expected to supply the PICA territory. This procedure was safely performed. Conclusion Early endovascular intervention should be considered in the treatment of dissecting aneurysm of vertebral artery associated with DOPICA for patients with relatively long lesions even in unruptured cases.


Author(s):  
Arvind Kumar ◽  
Swarup Sohan Gandhi ◽  
Ashok Gandhi ◽  
Trilochan Srivastav ◽  
Devendra Purohit

AbstractPosterior circulation aneurysms are difficult to treat, and if an incorporated artery is arising from the neck of aneurysm, management becomes much more challenging. Here, we are describing a novel technique used to treat a patient with a large, wide-necked left vertebral artery (VA)-posterior inferior cerebellar artery (PICA) junctional aneurysm. PICA seems to be arising from the aneurysm neck, but the aneurysm neck was not very clearly defined. So, we placed a second microcatheter into PICA, which not only allowed the coils to be placed in the aneurysm, without disrupting the flow through PICA but also helpful in assessing the aneurysmal occlusion. This technique allowed coils to be placed successfully without compromising flow through PICA.


1993 ◽  
Vol 79 (1) ◽  
pp. 116-118 ◽  
Author(s):  
Kazuhiro Hongo ◽  
Shigeaki Kobayashi ◽  
Masanobu Hokama ◽  
Kenichiro Sugita

✓ A case of a 30-year-old man who showed progressive pyramidal tract signs caused by compression of the left vertebral artery is presented. Initial decompression of the vertebral artery by placing a piece of sponge between the artery and medulla had no long-term effect. The left vertebral artery distal to the origin of the posterior inferior cerebellar artery was then sectioned, decompressing the medulla oblongata. The patient's symptoms improved postoperatively. This is the first reported case of brain-stem compression by an elongated vertebral artery treated by sectioning of the artery.


1998 ◽  
Vol 89 (5) ◽  
pp. 822-824 ◽  
Author(s):  
Ramesh L. Sahjpaul ◽  
Muwaffak M. Abdulhak ◽  
Charles G. Drake ◽  
Robert R. Hammond

✓ The authors present the case of a 34-year-old man struck over the left mastoid region by a hockey puck, who suffered a fatal rupture of a left vertebral artery berry aneurysm. He became apneic within seconds of the injury and had no brainstem reflex within minutes. The postmortem examination showed massive subarachnoid hemorrhage in the posterior fossa and the remnants of a berry aneurysm near the intradural origin of the left vertebral artery, 11 mm proximal to the posterior inferior cerebellar artery. Rupture of a saccular aneurysm as a result of head trauma is rare. This is the first reported case of a posterior circulation aneurysm rupture as a result of head trauma.


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