scholarly journals Extremely tortuous superior cerebellar artery mimicking an aneurysm

2021 ◽  
Vol 12 ◽  
pp. 569
Author(s):  
Megumi Matsuda ◽  
Hideki Endo ◽  
Kohei Ishikawa ◽  
Ryota Nomura ◽  
Tomoaki Ishizuka ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Basilar Artery ◽  
Vascular Lesions ◽  
Superior Cerebellar Artery ◽  
Case Description ◽  
Unruptured Cerebral Aneurysm ◽  
Cerebellar Artery ◽  
The Right ◽  
Angiography Catheter

Background: An extremely tortuous superior cerebellar artery is a rare anomaly. We report a case of an extremely tortuous superior cerebellar artery mimicking an aneurysm. Case Description: A 77-year-old woman was initially diagnosed with unruptured cerebral aneurysm at the right basilar artery-superior cerebellar artery junction by magnetic resonance angiography. Catheter angiogram revealed that there was no apparent aneurysm at the basilar artery-superior cerebellar artery junction and the lesion was actually an extremely tortuous superior cerebellar artery. Conclusion: Although an extremely tortuous superior cerebellar artery is rare, it should be considered when examining other vascular lesions.

scholarly journals Morphological Characteristics of the Superior Cerebellar Artery/ Морфолошки Карактеристики На Горната Церебеларна Артерија

PRILOZI ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 80-84
Author(s):  
Ace Dodevski ◽  
Dobrila Tosovska Lazarova ◽  
Julija Zhivadinovik ◽  
Menka Lazareska ◽  
Elizabeta Stojovska-Jovanovska
Keyword(s):  
Basilar Artery ◽  
Morphological Characteristics ◽  
Clinical Work ◽  
Daily Basis ◽  
Superior Cerebellar Artery ◽  
Adult Type ◽  
New Techniques ◽  
Cerebellar Artery ◽  
The Right ◽  
The University

Abstract With the introduction of new techniques in diagnostic and interventional radiology and progress in micro neurosurgery, accurate knowledge of the brain blood vessels is essential for daily clinical work. The aim of this study was to describe the morphological characteristics of the superior cerebellar artery and to emphasize their clinical significance. In this study we examined radiographs of 109 patients who had CT angiography at the University Clinic for Radiology in Skopje, R. Macedonia. This study included 49 females and 60 males, ranging in age from 27 to 83 years; mean age 57.4 ± 11.8 years. In 105 patients SCA arose from the basilar artery on both sides as a single vessel. In two patients SCA arose as a duplicate trunk from the basilar artery. We found unilateral duplication on the right SCA in one patient, and bilateral duplication in one patient. In two patients was noticed origin of the SCA from PCA as a single trunk from adult type of the PCA. Through knowledge of the anatomy and variations of SCA is important for clinicians as well as basic scientists who deal with problems related to intracranial vasculature in daily basis for save performance of diagnostic and interventional procedures.

scholarly journals Impact of deep learning reconstruction on intracranial 1.5 T magnetic resonance angiography

2021 ◽  
Author(s):  
Koichiro Yasaka ◽  
Hiroyuki Akai ◽  
Haruto Sugawara ◽  
Taku Tajima ◽  
Masaaki Akahane ◽  
...  
Keyword(s):  
Image Analysis ◽  
Deep Learning ◽  
Magnetic Resonance ◽  
Image Quality ◽  
Magnetic Resonance Angiography ◽  
Basilar Artery ◽  
Signal To Noise Ratio ◽  
Superior Cerebellar Artery ◽  
Prepontine Cistern ◽  
Noise Ratio

Abstract Purpose The purpose of this study was to evaluate whether deep learning reconstruction (DLR) improves the image quality of intracranial magnetic resonance angiography (MRA) at 1.5 T. Materials and methods In this retrospective study, MRA images of 40 patients (21 males and 19 females; mean age, 65.8 ± 13.2 years) were reconstructed with and without the DLR technique (DLR image and non-DLR image, respectively). Quantitative image analysis was performed by placing regions of interest on the basilar artery and cerebrospinal fluid in the prepontine cistern. We calculated the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for analyses of the basilar artery. Two experienced radiologists evaluated the depiction of structures (the right internal carotid artery, right ophthalmic artery, basilar artery, and right superior cerebellar artery), artifacts, subjective noise and overall image quality in a qualitative image analysis. Scores were compared in the quantitative and qualitative image analyses between the DLR and non-DLR images using Wilcoxon signed-rank tests. Results The SNR and CNR for the basilar artery were significantly higher for the DLR images than for the non-DLR images (p < 0.001). Qualitative image analysis scores (p < 0.003 and p < 0.005 for readers 1 and 2, respectively), excluding those for artifacts (p = 0.072–0.565), were also significantly higher for the DLR images than for the non-DLR images. Conclusion DLR enables the production of higher quality 1.5 T intracranial MRA images with improved visualization of arteries.

scholarly journals Thrombectomy in posterior circulation stroke through persistent primitive trigeminal artery: A case report

2015 ◽  
Vol 21 (6) ◽  
pp. 715-718 ◽  
Author(s):  
MJHL Mulder ◽  
GJ Lycklama à Nijeholt ◽  
W Dinkelaar ◽  
TPW de Rooij ◽  
ACGM van Es ◽  
...  
Keyword(s):  
Posterior Circulation ◽  
Superior Cerebellar Artery ◽  
Trigeminal Artery ◽  
Left Hand ◽  
Persistent Primitive Trigeminal Artery ◽  
Cerebellar Artery ◽  
Intervention Patient ◽  
Primitive Trigeminal Artery ◽  
The Right ◽  
Neurovascular Anatomy

We describe a case of intra-arterial treatment (IAT) of acute posterior circulation occlusion in a patient with a persistent primitive trigeminal artery (PPTA). The patient presented with an acute left sided hemiparesis and loss of consciousness (Glasgow coma score of 5). Computed tomography angiography showed an acute occlusion of the right internal carotid artery (ICA), the PPTA, distal basilar artery (BA), right posterior cerebral artery (PCA), and right superior cerebellar artery (SCA). Stent-retriever assisted thrombectomy was not considered possible through the hypoplastic proximal BA. After passage of the proximal ICA occlusion, the right PCA and SCA were recanalized through the PPTA, with a single thrombectomy procedure. Ten days after intervention patient was discharged scoring optimal EMV with only a mild facial and left hand paresis remaining. PPTA is a persistent embryological carotid–basilar connection. Knowledge of existing (embryonic) variants in neurovascular anatomy is essential when planning and performing acute neurointerventional procedures.

scholarly journals Extreme Lateral Supracerebellar Infratentorial Approach to the Lateral Midbrain

2018 ◽  
Vol 79 (S 05) ◽  
pp. S415-S417
Author(s):  
M. Kalani ◽  
William Couldwell
Keyword(s):  
Cranial Nerves ◽  
Sudden Onset ◽  
Superior Cerebellar Artery ◽  
Entry Zone ◽  
Cerebellar Artery ◽  
Sensory Disturbances ◽  
History Of ◽  
Supracerebellar Infratentorial Approach ◽  
The Right ◽  
Piecemeal Resection

This video illustrates the case of a 52-year-old man with a history of multiple bleeds from a lateral midbrain cerebral cavernous malformation, who presented with sudden-onset headache, gait instability, and left-sided motor and sensory disturbances. This lesion was eccentric to the right side and was located in the dorsolateral brainstem. Therefore, the lesion was approached via a right-sided extreme lateral supracerebellar infratentorial (exSCIT) craniotomy with monitoring of the cranial nerves. This video demonstrates the utility of the exSCIT for resection of dorsolateral brainstem lesions and how this approach gives the surgeon ready access to the supracerebellar space, and cerebellopontine angle cistern. The lateral mesencephalic safe entry zone can be accessed from this approach; it is identified by the intersection of branches of the superior cerebellar artery and the fourth cranial nerve with the vein of the lateral mesencephalic sulcus. The technique of piecemeal resection of the lesion from the brainstem is presented. Careful patient selection and respect for normal anatomy are of paramount importance in obtaining excellent outcomes in operations within or adjacent to the brainstem.The link to the video can be found at: https://youtu.be/aIw-O2Ryleg.

scholarly journals Retrosigmoid Craniotomy for the Removal of Left Sided Tentorial and Posterior Fossa Meningioma Combined with Microvascular Decompression for Hemifacial Spasm

2018 ◽  
Vol 80 (S 03) ◽  
pp. S294-S295
Author(s):  
Yu-Wen Cheng ◽  
Chun-Yu Cheng ◽  
Zeeshan Qazi ◽  
Laligam N. Sekhar
Keyword(s):  
Facial Nerve ◽  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Preoperative Imaging ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Root Exit Zone ◽  
Tentorial Meningioma ◽  
Cerebellar Artery ◽  
The Right

This 68-year-old woman presented with repeated episodes of bilateral hemifacial spasm with headache for 5 years and with recent progression of left sided symptoms. Preoperative imaging showed a left sided tentorial meningioma with brain stem and cerebellar compression. Left facial nerve was compressed by the vertebral artery (VA) and the right facial nerve by the anterior inferior cerebellar artery (AICA). This patient underwent left side retrosigmoid craniotomy and mastoidectomy. The cisterna magna was drained to relax the brain. The tumor was very firm, attached to the tentorium and had medial and lateral lobules. The superior cerebellar artery was adherent to the lateral lobule of the tumor and dissected away. The tumor was detached from its tentorial base; we first removed the lateral lobule. Following this, the medial lobule was also completely dissected and removed. The root exit zone of cranial nerve (CN) VII was dissected and exposed. The compression was caused both by a prominent VA and AICA. Initially, the several pieces of Teflon felt were placed for the decompression. Then vertebropexy was performed by using 8–0 nylon suture placed through the VA media to the clival dura. A further piece of Teflon felt was placed between cerebellopontine angle region and AICA. Her hemifacial spasm resolved postoperatively, and she discharged home 1 week later. Postoperative imaging showed complete tumor removal and decompression of left CN VII. This video shows the complex surgery of microsurgical resection of a large tentorial meningioma and microvascular decompression with a vertebropexy procedure.The link to the video can be found at: https://youtu.be/N5aHN9CRJeM.

scholarly journals Pure epidural spinal cavernous haemangioma

2021 ◽  
Vol 12 ◽  
pp. 523
Author(s):  
Ragavan Manoharan ◽  
Jonathon Parkinson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Surgical Excision ◽  
Cavernous Haemangioma ◽  
Case Description ◽  
Resonance Imaging ◽  
Cavernous Hemangiomas ◽  
The Right ◽  
Spinal Epidural ◽  
Progressive Paraparesis

Background: Pure epidural spinal cavernous hemangiomas (SCH) account for only 4% of all spinal epidural lesions. Our literature review identified 61 publications reporting on, a total of 175 cases in the magnetic resonance imaging era. Here, we reviewed those cases, and have added our case of what appeared to be a multifocal SCH. Case Description: A 72-year-old male presented with a progressive paraparesis attributed to a T5/T6 dorsolateral extradural mass extending into the right T5/6 foramen. Surgical excision documented the lesion, histologically, was a SCH. A second similar lesion was noted involving the left C7/T1 foramen; as the patient was asymptomatic from this lesion, and no additional biopsy was performed. The patient returned to normal neurological function within 2 months postoperatively. Conclusions: Here, a 72-year-old male presented with a pathologically confirmed T5/T6 epidural SCH and a secondary C7/T1 foraminal lesion suspected to represent a secondary focus of an epidural SCH.

scholarly journals Retrosigmoid Approach for Trapping and Removal of a Distal Dissecting Superior Cerebellar Artery Aneurysm in a Child

2018 ◽  
Vol 80 (S 03) ◽  
pp. S335-S338 ◽  
Author(s):  
Javier Ros de San Pedro
Keyword(s):  
Artery Aneurysm ◽  
Vascular Lesion ◽  
Retrosigmoid Approach ◽  
Vascular Lesions ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Unsteady Gait ◽  
Cerebellar Artery ◽  
Preoperative Magnetic Resonance ◽  
Magnetic Resonance Imaging Mri

Objectives To demonstrate the feasibility of the retrosigmoid craniotomy for surgical management of vascular lesions located in the cerebellopontine angle (CPA). Method A previously healthy 2-year-old boy presented a sudden episode of torticollis to the left while sleeping. This episode was selflimited but it occurred two more times in a 6-day span. Torticollis worsened in the upright position, caused unsteady gait and refusal to walk from the child. The preoperative magnetic resonance imaging (MRI) showed the presence of a round, heterogenous vascular lesion in the left CPA. The lesion clearly enhanced after contrast administration. The preoperative angiography demonstrated the absence of left anterior inferior cerebellar artery anterior inferior cerebellar artery (AICA), being the left superior cerebellar artery (SCA) the supplier of the left lateral cerebellum. A blurred blush on the distal left SCA was compatible with a fusiform aneurysm. A standard retrosigmoid approach was planned for trapping and removal of the aneurysm. Results Through a left retrosigmoid craniotomy the aneurysm was approached, along with the different neurovascular structures of the CPA. The aneurysm leaned on the VII, VIII nerves complex and the superior petrosal vein, while tightly attached to the lateral cerebellum. Both proximal and distal SCA segments to the aneurysm were dissected, clipped, and divided for a complete trapping. Finally, the aneurysm was completely detached and removed in a whole piece. The patient fully recovered after surgery with no relapse of his symptoms. Conclusion The retrosigmoid craniotomy is a versatile approach that permits wide exposure of all CPA structures and adequate removal of distal aneurysms located in those cerebellar arteries supplying the lateral cerebellum.The link to the video can be found at: https://youtu.be/oEVfy4goFYM.

scholarly journals Direct puncture of the V3 segment of the vertebral artery in acute basilar artery stroke: an alternative approach in desperate circumstances

2019 ◽  
Vol 12 (8) ◽  
pp. e231335 ◽  
Author(s):  
Sean Thomas O’Reilly ◽  
Ian Rennie ◽  
Jim McIlmoyle ◽  
Graham Smyth
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Left Vertebral Artery ◽  
Basilar Artery Thrombosis ◽  
Direct Puncture ◽  
Alternative Approach ◽  
Cerebellar Artery ◽  
First Pass ◽  
The Right

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.

Catastrophic cerebral infarction during extracorporeal life support due to a rare anomaly in the circle of Willis

2019 ◽  
Vol 29 (5) ◽  
pp. 816-817 ◽  
Author(s):  
Aiko Sonobe ◽  
Hideyuki Kato ◽  
Bryan J Mathis ◽  
Yuji Hiramatsu
Keyword(s):  
Computed Tomography ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Carotid Artery ◽  
Cerebral Infarction ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Circle Of Willis ◽  
Neurological Injury ◽  
The Right

Abstract During extracorporeal life support (ECLS) in infants, cannulation of the right common carotid artery may result in a devastating ischaemic neurological injury. Herein, we present a case of an infant who encountered bilateral cerebral infarction during ECLS via the right carotid artery due to a rare and tragic anomaly of the circle of Willis. The magnetic resonance angiography complemented computed tomography in diagnosing the infarction and identifying this unique anatomy.

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