Paediatric Dissecting Aneurysm of the Posterior Cerebral Artery

Aneurysms in children are rare. We describe a large spontaneous dissecting aneurysm of the posterior cerebral artery. The clinical presentation was characterized by headache as the sole symptom due to a mass effect leading to hydrocephalus. Acute treatment with a temporary ventricular shunt was followed by occlusion of the aneurysm via an endovascular approach leading to a complete recovery of the patient.

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Clinical Features of Aneurysms of the Posterior Cerebral Artery: A 15-year Experience with 21 Cases

Neurosurgery ◽

10.1227/01.neu.0000156199.53041.32 ◽

2005 ◽

Vol 56 (4) ◽

pp. 662-670 ◽

Cited By ~ 39

Author(s):

Jun-ichiro Hamada ◽

Motohiro Morioka ◽

Shigetoshi Yano ◽

Tatemi Todaka ◽

Yutaka Kai ◽

...

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Mass Effect ◽

Sudden Onset ◽

Dissecting Aneurysm ◽

University Hospital ◽

Surgical Approaches ◽

Good Recovery ◽

Cerebral Contusion ◽

Homonymous Hemianopsia

Abstract OBJECTIVE: To investigate the characteristic clinical behavior and develop guidelines for the clinical management of posterior cerebral artery aneurysms, we reviewed 21 cases treated during a 15-year period. METHODS: Between 1988 and 2002, we treated 21 patients (10 male, 11 female; mean age, 49.8 yr) with posterior cerebral artery aneurysms at Kumamoto University Hospital and its affiliated hospitals. Data relating to the clinical, radiological, and surgical approaches were analyzed. RESULTS: There were 20 saccular aneurysms, 6 of which were giant or large aneurysms, and 1 dissecting aneurysm. Of the 21 patients, 15 presented with subarachnoid hemorrhage; in 3 patients, an unruptured saccular aneurysm was found incidentally during an evaluation for other cerebral pathological conditions. Two patients presented with progressive homonymous hemianopsia because of the mass effect of the aneurysm, and 1 patient experienced the sudden onset of homonymous hemianopsia because of thrombosis of the aneurysm and afferent artery. Open or endovascular surgery was performed in 19 patients: 14 made a good recovery, 2 had a moderate disability because of angiospasm or infarction after aneurysm trapping, 1 had a severe disability because of angiospasm and cerebral contusion, and 2 died because of severe angiospasm. Of 2 conservatively treated patients, 1 made a good recovery but the other died as a result of rebleeding. CONCLUSION: Posterior cerebral artery aneurysms have specific clinical characteristics compared with aneurysms located elsewhere. The aneurysmal site and size and the surgical technique did not significantly influence treatment outcomes.

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Traumatic dissecting pathology of posterior cerebral artery: a report of two cases—aneurysm and pial arteriovenous fistula

BMJ Case Reports ◽

10.1136/bcr-2020-237722 ◽

2021 ◽

Vol 14 (5) ◽

pp. e237722

Author(s):

Vignesh Selvamurugan ◽

Surya Nandan Prasad ◽

Vivek Singh ◽

Zafar Neyaz

Keyword(s):

Arteriovenous Fistula ◽

Cerebral Artery ◽

Road Traffic ◽

Posterior Cerebral Artery ◽

Case Reports ◽

Dissecting Aneurysm ◽

Parent Vessel ◽

Vessel Occlusion ◽

Parent Vessel Occlusion ◽

Pial Arteriovenous Fistula

We present two cases of 17-year-old man and 10-year-old boy presenting with subarachnoid haemorrhage and a history of road traffic accident. One patient had dissecting aneurysm of the posterior cerebral artery (PCA), and the other patient had partially thrombosed aneurysm on CT angiography. On digital subtraction angiography of the second patient, there was formation of PCA pontomesencephalic vein pial arteriovenous fistula (PAVF). Both the patients underwent endovascular treatment: stent-assisted coiling for aneurysm and coiling with parent vessel occlusion for PAVF. There were no procedural complications. Follow-up angiography showed no residual aneurysm or fistula. Trauma is one of the recognised causes of dissection, and intracranial dissections can present as stenotic lesions, aneurysms or fistulas, depending on the pathology. Traumatic dissecting PCA aneurysm has been reported in only two case reports previously, and post-traumatic PAVF in PCA has not been reported.

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Stent-Assisted Coil Embolization for Acute Ruptured Dissecting Aneurysm at the P2 Segment of the Posterior Cerebral Artery: A Case Report

Journal of Neuroendovascular Therapy ◽

10.5797/jnet.cr.2021-0054 ◽

2021 ◽

Author(s):

Takashi Mitsuhashi ◽

Hidenori Oishi ◽

Kensaku Makino ◽

Joji Tokugawa ◽

Atsuhito Fuse ◽

...

Keyword(s):

Case Report ◽

Cerebral Artery ◽

Coil Embolization ◽

Posterior Cerebral Artery ◽

Dissecting Aneurysm

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Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm

BMJ Case Reports ◽

10.1136/bcr-2015-011753 ◽

2015 ◽

pp. bcr2015011753 ◽

Cited By ~ 3

Author(s):

Kasra Khatibi ◽

Jeremy J Heit ◽

Nicholas A Telischak ◽

Jorina M Elbers ◽

Huy M Do

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Dissecting Aneurysm ◽

Papa Syndrome ◽

Cerebral Vascular

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Dissecting aneurysm of the posterior cerebral artery treated with proximal ligation

Surgical Neurology ◽

10.1016/0090-3019(92)90011-b ◽

1992 ◽

Vol 37 (5) ◽

pp. 394-401 ◽

Cited By ~ 17

Author(s):

Osamu Sasaki ◽

Takayuki Koizumi ◽

Yasushi Ito ◽

Takatoshi Sorimachi ◽

Tetsuo Koike ◽

...

Keyword(s):

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Dissecting Aneurysm

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Republished: Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-011753.rep ◽

2015 ◽

Vol 8 (8) ◽

pp. e29-e29 ◽

Cited By ~ 8

Author(s):

Kasra Khatibi ◽

Jeremy J Heit ◽

Nicholas A Telischak ◽

Jorina M Elbers ◽

Huy M Do

Keyword(s):

Subarachnoid Hemorrhage ◽

Young Patient ◽

Pyoderma Gangrenosum ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Dissecting Aneurysm ◽

Neurologic Deficit ◽

Papa Syndrome ◽

Pyogenic Arthritis ◽

Cerebral Vascular

A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

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Endovascular treatment of posterior cerebral artery aneurysms: a single center's experience of 55 cases

Journal of Neurosurgery ◽

10.3171/2016.1.jns152447 ◽

2017 ◽

Vol 126 (4) ◽

pp. 1094-1105 ◽

Cited By ~ 6

Author(s):

Xuanfeng Qin ◽

Feng Xu ◽

Yashengjiang Maimaiti ◽

Yongtao Zheng ◽

Bin Xu ◽

...

Keyword(s):

Endovascular Treatment ◽

Cerebral Artery ◽

Posterior Cerebral Artery ◽

Case Series ◽

Artery Occlusion ◽

Dissecting Aneurysm ◽

Attractive Alternative ◽

Parent Artery ◽

Parent Artery Occlusion

OBJECTIVE Aneurysms of the posterior cerebral artery (PCA) are uncommon. To date, a limited number of studies have examined the outcomes of endovascular treatment for PCA aneurysms. The authors' aim in this study is to report their experience with the endovascular treatment of PCA aneurysms. METHODS Between January 2007 and December 2014, 55 patients with 59 PCA aneurysms were treated using the endovascular approach at the authors' institution. Twenty-three patients had 25 saccular aneurysms, and 32 patients had 34 fusiform/dissecting aneurysms. The endovascular modalities included the following: 1) selective occlusion of the aneurysm (n = 22); 2) complete occlusion of the aneurysm and the parent artery (n = 20); 3) parent artery occlusion (n = 6); 4) partial coiling of the aneurysm and the parent artery (n = 5); and 5) occlusion of the dissecting aneurysm sac (n = 2). RESULTS The immediate angiographic results included 45 complete occlusions (82%), 2 nearly complete occlusions (4%), and 8 incomplete occlusions (14%). The mean follow-up period of 21.8 months in 46 patients showed 37 stable results, 6 further thromboses, and 3 recurrences. The final results included 41 complete occlusions (89%), 2 nearly complete occlusions (4%), and 3 incomplete occlusions (7%). Procedure-related complications included the following: 1) rebleeding (n = 1); 2) infarction (n = 4); and 3) perforation (n = 1). There was 1 (1.8%) procedure-related death due to rebleeding, and 2 (3.6%) non–procedure-related deaths due to severe subarachnoid hemorrhage. Clinical outcomes were excellent (Glasgow Outcome Scale 5) in 47 of 49 patients at the long-term follow-up. CONCLUSIONS PCA aneurysms may be effectively treated by different endovascular approaches with favorable clinical and radiological outcomes. However, patients who present with severe SAH still have an overall poor prognosis. Partial coiling of the aneurysm and the parent artery is an attractive alternative treatment for patients who may not tolerate parent artery occlusion. Further study with a larger case series is necessary for validation of the durability and efficacy of this treatment.

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