scholarly journals Subarachnoid hemorrhage then thrombosis of posterior inferior cerebellar artery dissection: is early surgical exploration warranted?

2015 ◽  
Vol 2015 (may12 1) ◽  
pp. bcr2015011740-bcr2015011740
Author(s):  
N. G. Alexiades ◽  
J. A. Ellis ◽  
P. M. Meyers ◽  
E. S. Connolly
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Dissection ◽  
Surgical Exploration ◽  
Cerebellar Artery

Republished: Subarachnoid hemorrhage then thrombosis of posterior inferior cerebellar artery dissection: is early surgical exploration warranted?

2015 ◽  
Vol 8 (6) ◽  
pp. e22-e22
Author(s):  
Nikita G Alexiades ◽  
Jason A Ellis ◽  
Philip M Meyers ◽  
E Sander Connolly
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Definitive Treatment ◽  
Artery Dissection ◽  
Acute Thrombosis ◽  
Cerebellar Artery ◽  
History Of ◽  
Diseased Vessel ◽  
Vessel Thrombosis

The natural history of spontaneous cerebral artery dissection and thrombosis remains uncertain. Concurrent subarachnoid hemorrhage further complicates the therapeutic approach. Thus the best strategy for managing patients with acute vessel thrombosis in the setting of subarachnoid hemorrhage is unclear. Here we present a case of spontaneous posterior inferior cerebellar artery dissection presenting with subarachnoid hemorrhage and acute thrombosis. Although the patient was initially managed conservatively, angiographic follow-up demonstrated recanalization of the diseased vessel, necessitating definitive treatment. Thus we propose that angiographic follow-up is necessary in the management of patients with subarachnoid hemorrhage in association with apparent vessel thrombosis.

Republished: Delayed subarachnoid hemorrhage 7 years after cerebellar infarction from traumatic vertebral artery dissection

2016 ◽  
Vol 9 (4) ◽  
pp. e9-e9
Author(s):  
Michael A Silva ◽  
Alfred P See ◽  
Priyank Khandelwal ◽  
Nirav J Patel ◽  
Mohammad Ali Aziz-Sultan
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Cerebellar Infarction ◽  
Radiographic Evidence ◽  
Vessel Injury ◽  
Cerebellar Artery ◽  
The Right

Vertebral artery dissection (VAD) is an important cause of ischemic stroke and subarachnoid hemorrhage (SAH). Dissections presenting with ischemia rarely cause SAH after more than a few hours, especially without radiographic evidence of pseudoaneurysm. We successfully treated a patient for persistent vessel injury presenting with SAH 7 years after presenting with extracranial subocclusive dissection of the right vertebral artery and an associated right posterior inferior cerebellar artery stroke. This is one of only three reported cases of delayed SAH occurring more than 2 weeks after an initial ischemic presentation of a VAD, and the only one without radiographic evidence of pseudoaneurysm at standard follow-up duration.

scholarly journals Subarachnoid Hemorrhage Caused by Ruptured Dissecting Aneurysm Arising From the Extracranial Distal Posterior Inferior Cerebellar Artery

2010 ◽  
Vol 50 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Homare NAKAMURA ◽  
Toshihide TANAKA ◽  
Takami HIYAMA ◽  
Shinji OKUBO ◽  
Tadashi KUDO ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
Cerebellar Artery

Endovascular Treatment of Bilateral Intracranial Vertebral Artery Dissecting Aneurysms Presenting With Subarachnoid Hemorrhage

2011 ◽  
Vol 70 (suppl_1) ◽  
pp. ons75-ons81 ◽  
Author(s):  
Yong Sam Shin ◽  
Byung Moon Kim ◽  
Se-Hyuk Kim ◽  
Sang Hyun Suh ◽  
Chang Woo Ryu ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Stent Insertion ◽  
Treatment Methods ◽  
Cerebellar Artery ◽  
Endovascular Methods ◽  
Dissecting Aneurysms

Abstract BACKGROUND: Optimal management of bilateral vertebral artery dissecting aneurysms (bi-VDAs) causing subarachnoid hemorrhage (SAH) remains unclear. OBJECTIVE: To investigate the treatment methods and outcomes of bi-VDA causing SAH. METHODS: Seven patients were treated endovascularly for bi-VDA causing SAH. Treatment methods and outcomes were evaluated retrospectively. RESULTS: Two patients were treated with 2 overlapping stents for both ruptured and unruptured VDAs, 2 with 2 overlapping stents and coiling for ruptured VDA and with conservative treatment for unruptured VDA, 1 with internal trapping (IT) for ruptured VDA and stent-assisted coiling for unruptured VDA, 1 with IT for ruptured VDA and 2 overlapping stents for unruptured VDA, and 1 with IT for ruptured VDA and a single stent for unruptured VDA. None had rebleeding during follow-up (range, 15-48 months). All patients had favorable outcomes (modified Rankin Scale score, 0-2). On follow-up angiography at 6 to 36 months, 9 treated and 2 untreated VDAs revealed stable or improved state, whereas 3 VDAs in 2 patients showed regrowth. Of the 3 recurring VDAs, 1 was initially treated with IT but recurred owing to retrograde flow to the ipsilateral posterior inferior cerebellar artery (PICA), the second was treated with single stent but enlarged, and the last was treated with 2 overlapping stents and coiling but recurred from the remnant sac harboring the PICA origin. All 3 recurred VDAs were retreated with coiling with or without stent insertion. CONCLUSION: Bilateral VDAs presenting with SAH were safely treated with endovascular methods. However, endovascular treatment may be limited for VDAs with PICA origin involvement.

Occult posterior inferior cerebellar artery dissection requiring endovascular treatment following pediatric head trauma: case report

2021 ◽  
pp. 1-6
Author(s):  
Patrick J Grover ◽  
Lauren Harris ◽  
Ayman M Qureshi ◽  
Adam Rennie ◽  
Fergus Robertson ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Vascular Imaging ◽  
Artery Dissection ◽  
Pediatric Traumatic Brain Injury ◽  
Pediatric Head Trauma ◽  
Cerebellar Artery ◽  
Trauma Case ◽  
High Level

This is the eighth case report of a pediatric dissecting posterior inferior cerebellar artery aneurysm. The authors present the case of a 13-year-old boy who presented with posttraumatic posterior fossa subdural, subarachnoid, and intraventricular hemorrhage with hydrocephalus. Initial vascular imaging findings were negative; however, a high level of suspicion is necessary. The aneurysm was identified on day 20, after recurrence of hydrocephalus, and was treated with endovascular vessel sacrifice. The patient made a good recovery. It is important to consider arterial dissection in pediatric traumatic brain injury, especially with suspicious findings on initial CT scan and clinical presentation out of proportion to the mechanism of injury. Delayed vascular imaging is imperative for appropriate management.

scholarly journals Treatment of Dissecting Vertebral Aneurysm

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 155-160 ◽  
Author(s):  
Y. Kai ◽  
J. Hamada ◽  
M. Morioka ◽  
T. Todaka ◽  
T. Mizuno ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
The Other ◽  
Cerebellar Artery ◽  
Retrograde Filling ◽  
Angiographic Evidence ◽  
Vertebral Aneurysm ◽  
Proximal Occlusion ◽  
Dissecting Aneurysms

We report 17 patients with dissecting aneurysm of the vertebral artery (VA) who were treated by direct surgery (n=8) or interventional surgery (n=9). Eight patients presented with subarachnoid hemorrhage (SAH) and nine with ischemia. Ten patients were treated by trapping of the aneurysm that was occlusion of the VA on both sides of aneurysm (direct surgery, n=2; interventional surgery, n=8). The other seven patients were treated by ligation of the VA proximal to the aneurysm (direct surgery, n=6; interventional surgery, n=1). Two patients underwent transposition of the posterior inferior cerebellar artery (PICA). In 15 patients, there were no major complications. Two patients who had been treated by proximal occlusion of the VA developed rebleeding and ischemia due to persistent retrograde filling of the dissecting site. We suggest that angiographic evidence of retrograde filling of the dissecting site should have been considered as an indication for trapping. Trapping of VA dissecting aneurysms is easier and safer by interventional surgery than by direct surgery.

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