scholarly journals Spontaneous Thrombosis of Ruptured Vertebral Dissecting Aneurysm after Occipital Artery-Posterior Inferior Cerebellar Artery Anastomosis and Proximal Vertebral Artery Occlusion: Case Report.

2001 ◽  
Vol 29 (6) ◽  
pp. 430-434
Author(s):  
Masahiko KAWANISHI ◽  
Keiko IRIE ◽  
Nobuyuki KAWAI ◽  
Katsuzo KUNISHIO ◽  
Seigo NAGAO
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Occipital Artery ◽  
Spontaneous Thrombosis ◽  
Vertebral Artery Occlusion ◽  
Cerebellar Artery

OCCIPITAL ARTERY-TO-POSTERIOR INFERIOR CEREBELLAR ARTERY BYPASS FOR TREATMENT OF BILATERAL VERTEBRAL ARTERY OCCLUSION: THE ROLE OF QUANTITATIVE MAGNETIC RESONANCE ANGIOGRAPHY NONINVASIVE OPTIMAL VESSEL ANALYSIS

Neurosurgery ◽  
2009 ◽  
Vol 64 (4) ◽  
pp. E779-E781 ◽  
Author(s):  
Robert M. Starke ◽  
Mark Chwajol ◽  
Daniel Lefton ◽  
Chandranath Sen ◽  
Alejandro Berenstein ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vertebral Artery ◽  
Artery Bypass ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Occipital Artery ◽  
Vertebrobasilar Insufficiency ◽  
Vertebral Arteries ◽  
Vertebral Artery Occlusion ◽  
Cerebellar Artery

Abstract OBJECTIVE Patients with partial or complete bilateral vertebral artery occlusion often present with signs and symptoms of transient ischemic attacks or infarction. Advances in phase contrast magnetic resonance imaging have led to noninvasive assessment of volumetric blood flow rates and direction that help in the workup and management of these patients. CLINICAL PRESENTATION We present the case of a patient with symptoms of vertebrobasilar insufficiency without previous transient ischemic attacks or stroke. Quantitative magnetic resonance angiography (QMRA) demonstrated bilateral vertebral artery occlusion with reversal of flow in the basilar and vertebral arteries to the level of the posterior inferior cerebellar arteries bilaterally. A prominent right posterior communicating artery filled the basilar artery and proximal vertebral arteries. INTERVENTION The presence of reversal and diminished flow in the basilar and vertebral arteries suggested that occipital artery-to-posterior inferior cerebellar artery bypass would improve posterior circulation, relieve symptoms, and reduce the risk of infarction. Postoperative QMRA and angiography confirmed revascularization, and QMRA confirmed correction of blood flow direction. CONCLUSION This case illustrates the potential of QMRA as part of a comprehensive cerebrovascular assessment, operative planning, and follow-up of patients with vertebrobasilar insufficiency.

Superficial temporal and occipital artery bypass pedicles to superior, anterior inferior, and posterior inferior cerebellar arteries for vertebrobasilar insufficiency

1990 ◽  
Vol 72 (4) ◽  
pp. 554-558 ◽  
Author(s):  
James I. Ausman ◽  
Fernando G. Diaz ◽  
Dante F. Vacca ◽  
Balaji Sadasivan
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Superficial Temporal Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Occipital Artery ◽  
Vertebrobasilar Insufficiency ◽  
Cerebellar Artery ◽  
Artery Disease

✓ Eighty-three patients underwent 85 intracranial to extracranial pedicle bypass anastomosis procedures to the posterior circulation. There were 15 patients with occipital artery (OA) to posterior inferior cerebellar artery (PICA) anastomosis, 20 patients with OA to anterior inferior cerebellar artery (AICA) anastomosis, and 50 patients with superficial temporal artery (STA) to superior cerebellar artery (SCA) anastomosis. All patients had transient ischemic attacks (TIA's) suggestive of vertebrobasilar ischemia. Twenty-seven patients had crescendo TIA's or stroke in evolution and were considered to be clinically unstable. All patients had severe bilateral distal vertebral artery or basilar artery disease. Twenty-two patients had bilateral vertebral artery occlusion and three had basilar artery occlusion. In this series, 69% had complete resolution of symptoms; the mortality rate was 8.4% and the morbidity rate 13.3%. Clinically stable patients did better than unstable patients. The STA-SCA anastomosis was well tolerated and technically less demanding than the OA-PICA or OA-AICA anastomosis procedures. Patients with symptomatic severe bilateral vertebral or basilar artery disease have a grave prognosis and the option of a surgical arterial pedicle revascularization procedure should be offered to them.

scholarly journals Stent-Jack Technique for Ruptured Vertebral Artery Dissecting Aneurysm Involving the Origin of Posterior Inferior Cerebellar Artery

2020 ◽  
Vol 15 (2) ◽  
pp. 84-88
Author(s):  
Toshitsugu Terakado ◽  
Yasunobu Nakai ◽  
Go Ikeda ◽  
Kazuaki Tsukada ◽  
Sho Hanai ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Careful Attention ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Vertebral Artery Dissecting Aneurysm ◽  
Vertebral Artery Stenting

We herein report a case of a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery that was treated using the stent-jack technique. After parent artery occlusion of the distal vertebral artery, stenting of the posterior inferior cerebellar artery was performed. Further coiling was needed because distal vertebral artery recanalization occurred due to transformation of the coil mass. The stent-jack technique for a ruptured vertebral artery dissecting aneurysm involving the origin of the posterior inferior cerebellar artery is effective; however, careful attention to recanalization after stenting is needed due to transformation of the coil mass.

Vertebral artery occlusion after subarachnoid hemorrhage from a dissecting aneurysm of the vertebral artery: Case report

1997 ◽  
Vol 47 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Toshihiro Yasui ◽  
Hiroshige Kishi ◽  
Hiroaki Sakamoto ◽  
Masaki Komiyama ◽  
Yoshiyasu Iwai ◽  
...  
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
Vertebral Artery ◽  
Artery Occlusion ◽  
Dissecting Aneurysm ◽  
Vertebral Artery Occlusion

Occipital artery to p3 segment of posterior inferior cerebellar artery bypass in treating a complex fusiform aneurysm

2020 ◽  
Vol 13 (6) ◽  
pp. e235023
Author(s):  
Peyton L Nisson ◽  
Michael A McNamara ◽  
Xiaolong Wang ◽  
Xinmin Ding
Keyword(s):  
Case Report ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
Neurological Deficits ◽  
Endovascular Coiling ◽  
Occipital Artery ◽  
Cerebellar Artery ◽  
Arterial Bypass Graft

We provide a case report of a 58-year-old man who presented with a ruptured fusiform dissecting aneurysm located at the junction of the vertebral artery and posterior inferior cerebellar artery (PICA). Due to the lesion’s complexity, a two-step approach was planned for revascularisation of PICA using the occipital artery (OA) prior to coiling embolisation. An end-to-side OA–PICA bypass was performed with implantation at the caudal loop of the p3 PICA segment. Fifteen days after the procedure, the aneurysm underwent stent-assisted coiling for successful obliteration of the aneurysm. The patient tolerated this procedure well and now at 1.5 years of follow-up remains free from any neurological deficits (modified Rankin Score 0). This case report illustrates one of the unique scenarios where both the vascular territory involved and morphological features of the aneurysm prohibited the use of more conventional means, necessitating the use of an arterial bypass graft for successful treatment of this lesion. As open vascular surgery is becoming less common in the age of endovascular coiling, our article uniquely reports on the combined use of both endovascular and microsurgical techniques to treat a complex aneurysm of the posterior circulation.

Sign in / Sign up

Export Citation Format

Share Document