scholarly journals Successful endovascular treatment of a ruptured bihemispheric posterior inferior cerebellar artery aneurysm: illustrative case

2021 ◽  
Vol 2 (7) ◽  
Author(s):  
Shingo Nishihiro ◽  
Tomotsugu Ichikawa ◽  
Yu Takahashi ◽  
Yuichi Hirata ◽  
Nobuhiko Kawai ◽  
...  
Keyword(s):  
Anatomical Variation ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Ruptured Aneurysm ◽  
Cerebellar Hemisphere ◽  
Parent Artery ◽  
Illustrative Case ◽  
Related Complication ◽  
Cerebellar Artery ◽  
Sudden Headache

BACKGROUND Normal posterior inferior cerebellar artery (PICA) anatomy is highly variable, but bihemispheric PICA crossing the midline to supply the vascular territory of bilateral cerebellar hemisphere is rare. Herein, the authors reported a rare case of ruptured aneurysm that was associated with bihemispheric PICA and successfully treated endovascularly. OBSERVATIONS A 46-year-old woman presented with sudden headache and loss of consciousness because of an intraventricular hemorrhage due to a ruptured aneurysm that was associated with the bihemispheric PICA. Angiography revealed that the aneurysm was located at the bifurcation between the bihemispheric PICA and the bilateral distal PICA. The ruptured aneurysm was successfully occluded using coil embolization, which preserved the parent artery with no procedural-related complication. LESSONS To the best of the authors’ knowledge, this was the first report of a ruptured aneurysm associated with bihemispheric PICA being successfully treated endovascularly. Aneurysm formation may be accelerated by hemodynamic stress and vascular fragility. For neurosurgeons and neurointerventionalists, it is important to understand the anatomical variation of PICA, especially bihemispheric PICA, which is a potential risk factor for a fatal stroke.

Combined surgical and endovascular treatment of a giant vertebral artery aneurysm in a child

1994 ◽  
Vol 81 (2) ◽  
pp. 304-307 ◽  
Author(s):  
Mazen H. Khayata ◽  
Robert F. Spetzler ◽  
Jan J. A. Mooy ◽  
James M. Herman ◽  
Harold L. Rekate
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Left Vertebral Artery ◽  
Parent Artery ◽  
Content Type ◽  
Cerebellar Artery ◽  
Coil Occlusion ◽  
Surgical Bypass

✓ The case is presented of a 5-year-old child who suffered a subarachnoid hemorrhage from a giant left vertebral artery-posterior inferior cerebellar artery (PICA) aneurysm. Initial treatment consisted of surgical occlusion of the parent vertebral artery combined with a PICA-to-PICA bypass. Because of persistent filling of the aneurysm, the left PICA was occluded at its takeoff from the aneurysm. Endovascular coil occlusion of the aneurysm and the distal left vertebral artery enabled complete elimination of the aneurysm. Follow-up magnetic resonance imaging and arteriography performed 6 months postoperatively showed persistent occlusion and elimination of the mass effect. Combined surgical bypass and endovascular occlusion of the parent artery may be a useful adjunct in the management of these aneurysms.

scholarly journals Treatment of a ruptured aneurysm involved in a double origin of the posterior inferior cerebellar artery

2015 ◽  
Vol 21 (4) ◽  
pp. 451-455 ◽  
Author(s):  
Taku Uchiyama ◽  
Hiroaki Okamoto ◽  
Atsushi Ogata ◽  
Yutaka Tajima ◽  
Yukinori Takase ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Anatomical Variation ◽  
Posterior Inferior Cerebellar Artery ◽  
Balloon Occlusion ◽  
Ruptured Aneurysm ◽  
Occlusion Test ◽  
Balloon Occlusion Test ◽  
Cerebellar Artery ◽  
Double Origin ◽  
Distal Flow

Double origin of the posterior inferior cerebellar artery (DOPICA) is a rare anatomical variation, and can be associated with intracranial aneurysm formation. We describe a 66-year-old woman case of a ruptured aneurysm involved in a DOPICA. We performed aneurysmal coil embolization for the ruptured aneurysm involved in the cranial channel of DOPICA, but the aneurysm relapsed two months later. We subsequently performed internal trapping of the cranial channel because of well visualization of the distal flow by the balloon occlusion test. Endovascular trapping of a channel is one of the effective treatments of an aneurysm involved in DOPICA.

scholarly journals Treatment of intracranial vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery origin

2019 ◽  
Vol 10 ◽  
pp. 116 ◽  
Author(s):  
Jason A. Chen ◽  
Matthew C. Garrett ◽  
Anton Mlikotic ◽  
James I. Ausman
Keyword(s):  
Vertebral Artery ◽  
Complex Disease ◽  
Treatment Options ◽  
Posterior Inferior Cerebellar Artery ◽  
Treatment Strategies ◽  
Dissecting Aneurysm ◽  
Parent Artery ◽  
Illustrative Case ◽  
Parent Vessel ◽  
Cerebellar Artery

Background: Vertebral artery dissecting aneurysm (VADA) involving the origin of the posterior inferior cerebellar artery (PICA) is a complex disease entity in which the dual goals of preventing future rebleeding and maintaining perfusion of the lateral medulla must be considered. We present an illustrative case and review the literature surrounding treatment strategies. Case Description: We report a patient presenting with extensive subarachnoid hemorrhage due to rupture of an intracranial VADA involving the PICA origin. After consideration of the patient’s cerebral vasculature and robustness of collaterals, a flow-diverting stent was placed with angiographic resolution of the lesion and maintenance of antegrade PICA flow. Ultimately, the patient experienced a contralateral intraparenchymal hemorrhage leading to death. Review of the literature identified 124 cases of VADA involving the PICA origin described over the past decade. The methods of surgical and endovascular treatment of these cases were reviewed, with particular focus on the rationale of treatment, outcomes, and complications. Conclusion: Numerous treatment options for VADA involving PICA have been reported with different risk and benefit profiles. Flow-diverting stents appear to offer the most favorable balance of securing the aneurysm and avoiding medullary infarction, but the risks and optimal anti-thrombotic treatment strategy are incompletely understood. In select cases, in which the surgical risk is low or in which the anatomy is favorable (e.g., nondominant parent vessel or robust collateral circulation in the involved territories), parent artery trapping with or without microsurgical revascularization can be considered.

scholarly journals Treatment of Unruptured Vertebral Artery Aneurysm Involving Posterior Inferior Cerebellar Artery With Pipeline Embolization Device

2021 ◽  
Vol 12 ◽  
Author(s):  
Weiqi Fu ◽  
Huijian Ge ◽  
Gang Luo ◽  
Xiangyu Meng ◽  
Jiejun Wang ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Pipeline Embolization Device ◽  
Complete Occlusion ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery

Background: Treatment of unruptured vertebral artery aneurysm involving posterior inferior cerebellar artery (PICA) is challenging. The experience of pipeline embolization device (PED) therapy for these lesions is still limited.Objective: To evaluate the safety and efficacy of the PED for unruptured vertebral artery aneurysm involving PICA.Methods: Thirty-two patients with unruptured vertebral artery aneurysm involving PICA underwent treatment with PED were retrospectively identified. Procedure-related complications, PICA patency, clinical, and angiographic outcomes were analyzed.Results: Thirty-two aneurysms were successfully treated without any procedure-related complications. Images were available in 30 patients (93.8%) during a period of 3–26 months follow-up (average 8.4 months), which confirmed complete occlusion in 17 patients (56.5%), near-complete occlusion in 9 patients (30%), and incomplete occlusion in one patient (3.3%). Parent artery occlusion (PAO) was occurred in 3 patients (10%). Twenty-eight of 30 PICA remained patent. The two occlusions of PICA were secondary to PAO. At a mean of 20.7 months (range 7–50 months) clinical follow-up, all the patients achieved a favorable outcome without any new neurological deficit.Conclusion: PED seems to be a safe and effective alternative endovascular option for patients with unruptured vertebral artery aneurysm involving PICA.

Fatal rupture following intra-aneurysmal embolization for the distal posterior inferior cerebellar artery aneurysm with parent artery preservation

2003 ◽  
Vol 105 (2) ◽  
pp. 117-120 ◽  
Author(s):  
Miki Fujimura ◽  
Michiharu Nishijima ◽  
Hiroshi Midorikawa ◽  
Kunihiko Umezawa ◽  
Toshiaki Hayashi ◽  
...  
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Parent Artery ◽  
Cerebellar Artery

Persistent Hypoglossal Artery Associated with a Ruptured Ipsilateral Posterior Inferior Cerebellar Artery Aneurysm

2007 ◽  
Vol 20 (5) ◽  
pp. 570-573 ◽  
Author(s):  
E. Uysal ◽  
M. Velioglu ◽  
E. Kara ◽  
S. Albayram ◽  
C. Islak ◽  
...  
Keyword(s):  
Rare Case ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Ruptured Aneurysm ◽  
Persistent Hypoglossal Artery ◽  
Hypoglossal Artery ◽  
Endovascular Occlusion ◽  
Cerebellar Artery

A rare case of persistent hypoglossal artery in conjuction with a ruptured aneurysm at the left proximal posterior inferior cerebellar artery (PICA) is presented. A ruptured PICA aneurysm was successfully treated by endovascular occlusion of the aneurym with coiling.

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