scholarly journals Rete mirabile of posterior inferior cerebellar artery: A rare cause of subarachnoid hemorrhage

2018 ◽  
Vol 24 (6) ◽  
pp. 662-665 ◽  
Author(s):  
Suresh Giragani ◽  
Santhosh K Pavunesan ◽  
Anandh Balasubramaniam ◽  
Vikas Agrawal ◽  
Surendar Alwala ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Internal Carotid ◽  
Clinical Presentation ◽  
Posterior Inferior Cerebellar Artery ◽  
Imaging Findings ◽  
Vertebral Arteries ◽  
Rete Mirabile ◽  
Cerebellar Artery ◽  
Collateral Network ◽  
Carotid And Vertebral Arteries

Rete mirabile is a congenital aberrant arterial collateral network resulting from abnormal embryonic activity during native vessel formation. Even though frequently observed in mammals, this entity is rare in humans except when there is hypoplasia, aplasia or narrowing of native vessels. Rete mirabile is reported involving internal carotid and vertebral arteries. Rete mirabile of the posterior inferior cerebellar artery (PICA) is not described in the literature. We report the clinical presentation, imaging findings and management of PICA rete mirabile formation with subarachnoid hemorrhage.

Spontaneous germinal matrix and intraventricular hemorrhage in prematurely born rabbits

1982 ◽  
Vol 56 (3) ◽  
pp. 404-410 ◽  
Author(s):  
Antonio V. Lorenzo ◽  
Keasley Welch ◽  
Scott Conner
Keyword(s):  
Intraventricular Hemorrhage ◽  
Internal Carotid ◽  
Germinal Matrix ◽  
Content Type ◽  
Vertebral Arteries ◽  
Rete Mirabile ◽  
Premature Babies ◽  
Near Term ◽  
The Brain ◽  
Carotid And Vertebral Arteries

✓ Spontaneous hemorrhage into the ventricles in premature babies is a major problem, and neither its cause nor its pathogenesis is understood. A model is presented for the study of germinal matrix and intraventricular hemorrhage in the preterm rabbit. This animal is particularly suitable because like the human, 1) the maximal growth of the brain occurs perinatally; 2) there is an abundant germinal matrix near term, and by birth this is substantially reduced; 3) there is no rete mirabile; 4) the blood flow to the brain is via internal carotid and vertebral arteries; 5) the maturation of the lungs is completed just before term; and 6) the rabbit pup can maintain a separate existence from the dam when delivered prematurely. Eight of 64 such animals were found to have developed spontaneous germinal matrix hemorrhage with or without rupture into the ventricles. Several physiological and chemical features characteristic of the premature rabbit are presented. The hemorrhage in the lagomorph might be a paradigm of that in infants, and its study may aid in the understanding of the pathogenesis of the process.

Fatal Subarachnoid Hemorrhage, with Brainstem and Cerebellar Infarction, Caused by Aspergillus Infection after Cerebral Aneurysm Surgery: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (5) ◽  
pp. 1147-1151 ◽  
Author(s):  
Toshiki Endo ◽  
Teiji Tominaga ◽  
Hidehiko Konno ◽  
Takashi Yoshimoto
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Presentation ◽  
Unknown Origin ◽  
Sudden Onset ◽  
Anterior Communicating Artery ◽  
Cerebellar Infarction ◽  
Vertebral Arteries ◽  
Cerebellar Artery ◽  
Mycotic Aneurysms ◽  
Intracranial Aspergillosis

Abstract OBJECTIVE AND IMPORTANCE: Intracranial aspergillosis has been reported to cause subarachnoid hemorrhage (SAH) attributable to ruptured mycotic aneurysms. We describe a case of Aspergillus arteritis that caused SAH without aneurysm formation, followed by successive brainstem and cerebellar infarction. CLINICAL PRESENTATION: A 50-year-old woman experienced a sudden onset of headache. Computed tomography demonstrated SAH. After angiography revealed an aneurysm of the anterior communicating artery, a complete neck-clipping operation was performed, without neurological deterioration. However, the patient experienced another episode of SAH on the 26th postoperative day. INTERVENTION: We repeated the craniotomy and confirmed that the clip was still intact. A second angiographic evaluation did not reveal an aneurysm or any other cause of hemorrhage. On the 30th postoperative day, magnetic resonance imaging demonstrated cerebellar infarction in the territory of the anteroinferior cerebellar artery. The patient died on the 40th postoperative day, after another episode of SAH and progressive cerebellar and brainstem infarction. The postmortem examination revealed destruction of the basilar artery and occlusion of the basilar and vertebral arteries attributable to Aspergillus arteritis. CONCLUSION: When a patient presents with SAH of unknown origin followed by cerebral infarction, Aspergillus arteritis should be included in the differential diagnosis. Earlier recognition of this fungal infection improves the prognosis.

Ruptured Aneurysm Originating From an Aberrant Medullary Branch of the Proximal Posterior Inferior Cerebellar Artery

Neurosurgery ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. E221-E221 ◽  
Author(s):  
Ji Hoon Phi ◽  
Sang Hyung Lee ◽  
Kyu Ri Son ◽  
Young Seob Chung
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Clinical Presentation ◽  
Cervical Spinal Cord ◽  
Posterior Inferior Cerebellar Artery ◽  
Small Branch ◽  
Cerebellar Artery ◽  
Time Of Operation ◽  
Communicating Branches ◽  
Arterial Branch

Abstract OBJECTIVE Aneurysms that arise from a small branch of the posterior inferior cerebellar artery (PICA) are very rare. All reported PICA branch aneurysms originated from the choroidal branches or PICA communicating branches. No aneurysms of the PICA medullary branch have been reported previously. CLINICAL PRESENTATION A 62-year-old woman presented with a subarachnoid hemorrhage and intraventricular hemorrhage. Angiography showed a globular-shaped aneurysm arising from an aberrant branch of the anterior medullary segment of the left PICA. At the time of operation, the arterial branch was found to send some perforators into to the medulla oblongata and cervical spinal cord. INTERVENTION Aneurysm trapping was performed. Postoperatively, the patient had a mild transient difficulty in swallowing that may have been caused by manipulation of the vagus nerve rootlets. CONCLUSION Aneurysms can develop from a proximal medullary branch of the PICA and lead to subarachnoid hemorrhage and intraventricular hemorrhage. Trapping can be judiciously attempted to treat this precarious aneurysm.

scholarly journals Endovascular Considerations in Traumatic Injury of the Carotid and Vertebral Arteries

2021 ◽  
Vol 38 (01) ◽  
pp. 053-063
Author(s):  
Ananth K. Vellimana ◽  
Jayson Lavie ◽  
Arindam Rano Chatterjee
Keyword(s):  
Natural History ◽  
Clinical Presentation ◽  
Traumatic Injury ◽  
Classification Systems ◽  
Endovascular Techniques ◽  
Traumatic Injuries ◽  
Cerebrovascular Injury ◽  
Vertebral Arteries ◽  
Carotid And Vertebral Arteries

AbstractCervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.

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.

Spontaneous dissection of bilateral internal carotid and vertebral arteries

2021 ◽  
Vol 14 (3) ◽  
pp. e241173
Author(s):  
Amr Ewida ◽  
Rashid Ahmed ◽  
Anqi Luo ◽  
Hesham Masoud
Keyword(s):  
Weight Loss ◽  
Internal Carotid ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Review Of Literature ◽  
Vertebral Arteries ◽  
Ischaemic Attack ◽  
Middle Aged Adults ◽  
Spontaneous Dissection ◽  
Carotid And Vertebral Arteries

Spontaneous dissection of the major arteries of the neck is known to increase the risk of stroke or transient ischaemic attack in young and middle-aged adults. Most of the reported cases of arterial dissections in the neck involve one or both paired extracranial carotid or vertebral arteries. Spontaneous dissection of the bilateral internal carotid and vertebral arteries is extremely rare. We report a case of spontaneous bilateral internal carotid artery and vertebral artery dissection while using a prescribed pill for weight loss which contained amphetamine derivative. A review of literature is also provided.

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