Transoral transclival clipping of anterior inferior cerebellar artery aneurysm using new rotating applier

1991 ◽  
Vol 75 (3) ◽  
pp. 483-485 ◽  
Author(s):  
H. Alan Crockard ◽  
Turgut Koksel ◽  
Nigel Watkin
Keyword(s):  
Basilar Artery ◽  
Artery Aneurysm ◽  
Transoral Surgery ◽  
Anterior Inferior Cerebellar Artery ◽  
Content Type ◽  
Aneurysm Clip ◽  
Dural Closure ◽  
Cerebellar Artery ◽  
Fine Print

✓ A large, partly calcified aneurysm buried in the pons and arising from the junction of the basilar artery and the anterior inferior cerebellar artery was successfully occluded using a variangle aneurysm clip with a new rotating pistol-grip applier which allowed transoral access. The authors believe that the new applier, used in association with the current techniques for dural closure, allows for safe transoral surgery for basilar aneurysms.

Distal anterior inferior cerebellar artery aneurysms

2002 ◽  
Vol 97 (3) ◽  
pp. 692-696 ◽  
Author(s):  
Eric L. Zager ◽  
Ellen G. Shaver ◽  
Robert W. Hurst ◽  
Eugene S. Flamm
Keyword(s):  
Artery Aneurysm ◽  
Distal Segment ◽  
Anterior Inferior Cerebellar Artery ◽  
Management Options ◽  
Content Type ◽  
Von Hippel Lindau ◽  
Cerebellar Artery ◽  
Distal Branch ◽  
Acute Subarachnoid Hemorrhage ◽  
Fine Print

✓ Aneurysms of the distal anterior inferior cerebellar artery (AICA) are rare; fewer than 100 cases have been reported. The authors detail their experience with four cases and present endovascular as well as microsurgical management options. The medical records and neuroimaging studies obtained in four patients who were treated at a single institution were reviewed. Clinical presentations, neuroimaging and intraoperative findings, and clinical outcomes were analyzed. There were three men and one woman; their mean age was 43 years. Two patients presented with acute subarachnoid hemorrhage (SAH), and two presented with ataxia and vertigo (one with tinnitus, the other with hearing loss). Angiographic studies demonstrated aneurysms of the distal segment of the AICA. In one patient with von Hippel—Lindau syndrome and multiple cerebellar hemangioblastomas, a feeding artery aneurysm was found on a distal branch of the AICA. Three of the patients underwent successful surgical obliteration of their aneurysms, one by clipping, one by trapping, and one by resection along with the tumor. The fourth patient underwent coil embolization of the distal AICA and the aneurysm. All patients made an excellent neurological recovery. Patients with aneurysms in this location may present with typical features of an acute SAH or with symptoms referable to the cerebellopontine angle. Evaluation with computerized tomography, magnetic resonance (MR) imaging, MR angiography, and digital subtraction angiography should be performed. For lesions distal to branches coursing to the brainstem, trapping and aneurysm resection are viable options that do not require bypass. Endovascular obliteration is also a reasonable option, although the possibility of retrograde thrombosis of the AICA is a concern.

Anterior inferior cerebellar artery aneurysm

1983 ◽  
Vol 59 (4) ◽  
pp. 697-702 ◽  
Author(s):  
Akira Nishimoto ◽  
Shunichiro Fujimoto ◽  
Shoji Tsuchimoto ◽  
Yuzo Matsumoto ◽  
Kazuo Tabuchi ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Cerebellopontine Angle ◽  
Artery Aneurysm ◽  
Anterior Inferior Cerebellar Artery ◽  
Content Type ◽  
Aneurysm Neck ◽  
The Third ◽  
Suboccipital Craniectomy ◽  
Cerebellar Artery ◽  
Fine Print

✓ Three cases of aneurysms of the anterior inferior cerebellar artery are reported. Two of the aneurysms were located in the cerebellopontine angle and one in the ventral portion of the pons. Through a suboccipital craniectomy, neck clipping was perfomed on one aneurysm, neck ligation on another, and coating on the third. A discussion of the surgical procedures and complications includes a review of previous reports.

Simulation of the surgical manipulation involved in clipping a basilar artery aneurysm: concepts of virtual clipping

2000 ◽  
Vol 93 (2) ◽  
pp. 355-360 ◽  
Author(s):  
Toru Koyama ◽  
Kazuhiro Hongo ◽  
Yuichiro Tanaka ◽  
Shigeaki Kobayashi
Keyword(s):  
Cerebral Aneurysm ◽  
Basilar Artery ◽  
Morphological Changes ◽  
Three Dimensional ◽  
Artery Aneurysm ◽  
Content Type ◽  
Aneurysm Clip ◽  
Transsylvian Approach ◽  
Surgical Manipulation ◽  
Fine Print

✓ Despite recent advances in three-dimensional imaging based on a voxel-rendering method, these techniques do not simulate the morphological changes that occur during surgery. The authors' goal was to develop a computer-graphics model to simulate the manipulation that occurs during surgery when clipping a cerebral aneurysm.The authors developed an application program to interpolate the contours of models of an artery and an aneurysm clip. The center of displacement was determined inside the arterial model. The directions of displacement were changed to simulate saccular and broad-neck aneurysms, and the intensity of displacement was calculated by using a cosine-based formula. The morphological changes in a saccular aneurysm that may occur during clipping were calculated in x, y, and z coordinates by using sine- and cosine-based formulas. Clip movement was integrated with the aneurysm model, thus simulating the manipulation used during clipping of a cerebral aneurysm. Surgery performed to clip a basilar artery (BA) aneurysm via the transsylvian approach was simulated, in which displacement of the internal carotid artery and clipping of the BA aneurysm were necessary. The movements of an aneurysm clip and clip applicator were designed to represent those occurring when a surgeon actually manipulates a BA aneurysm.The authors have named this methodological tool “virtual clipping.” Use of this tool would assist the preoperative choice of clipping style and selection of the best clip.

Endovascular occlusion of intracranial vessels for curative treatment of unclippable aneurysms: report of 16 cases

1991 ◽  
Vol 75 (5) ◽  
pp. 694-701 ◽  
Author(s):  
Jonathan E. Hodes ◽  
Armand Aymard ◽  
Y. Pierre Gobin ◽  
Daniel Rüfenacht ◽  
Siegfried Bien ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cerebral Artery ◽  
Basilar Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Neurological Deficits ◽  
Parent Vessel ◽  
Content Type ◽  
Fine Print

✓ Among 121 intracerebral aneurysms presenting at one institution between 1984 and 1989, 16 were treated by endovascular means. All 16 lesions were intradural and intracranial, and had failed either surgical or endovascular attempts at selective exclusion with parent vessel preservation. The lesions included four giant middle cerebral artery (MCA) aneurysms, one giant anterior communicating artery aneurysm, six giant posterior cerebral artery aneurysms, one posterior inferior cerebellar artery aneurysm, one giant mid-basilar artery aneurysm, two giant fusiform basilar artery aneurysms, and one dissecting vertebral artery aneurysm. One of the 16 patients failed an MCA test occlusion and was approached surgically after attempted endovascular selective occlusion. Treatment involved pretreatment evaluation of cerebral blood flow followed by a preliminary parent vessel test occlusion under neuroleptic analgesia with vigilant neurological monitoring. If the test occlusion was tolerated, it was immediately followed by permanent occlusion of the parent vessel with either detachable or nondetachable balloon or coils. The follow-up period ranged from 1 to 8 years. Excellent outcomes were obtained in 12 cases with complete angiographic obliteration of the aneurysm and no new neurological deficits and/or improvement of the pre-embolization symptoms. Four patients died: two related to the procedure, one secondary to rupture of another untreated aneurysm, and the fourth from a postoperative MCA thrombosis after having failed endovascular test occlusion. The angiographic, clinical, and cerebral blood flow criteria for occlusion tolerance are discussed.

Treatment of aneurysms by excision or trapping with arterial reimplantation or interpositional grafting

1996 ◽  
Vol 85 (1) ◽  
pp. 178-185 ◽  
Author(s):  
Sang Youl Lee ◽  
Laligam N. Sekhar
Keyword(s):  
Superficial Temporal Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Giant Aneurysm ◽  
Temporal Artery ◽  
Left Vertebral Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Content Type ◽  
First Case ◽  
Cerebellar Artery ◽  
Fine Print

✓ The authors report three cases of ruptured, large or giant aneurysms that were treated by excision or trapping, followed by revascularization of distal vessels by means of arterial reimplantation or superficial temporal artery interpositional grafting. In the first case, a large serpentine aneurysm arising from the anterior temporal branch of the right middle cerebral artery (MCA) was excised and the distal segment of the anterior temporal artery was reimplanted into one of the branches of the MCA. In the second case, a giant aneurysm, fusiform in shape, arose from the rolandic branch of the MCA. This aneurysm was totally excised and the M3 branch in which it had been contained was reconstructed with an arterial interpositional graft. In the third case the patient, who presented with a subarachnoid hemorrhage, had a dissecting aneurysm that involved the distal portion of the left vertebral artery. In this case the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm and coursed onward to supply the brainstem. This aneurysm was managed by trapping and the PICA was reimplanted into the ipsilateral large anterior inferior cerebellar artery. None of the patients suffered a postoperative stroke and all recovered to a good or excellent postoperative condition. These techniques allowed complete isolation of the aneurysm from the normal blood circulation and preserved the blood flow through the distal vessel that came out of the aneurysm. These techniques should be considered as alternatives when traditional means of cerebral revascularization are not feasible.

Aneurysm in the internal auditory meatus

1971 ◽  
Vol 35 (5) ◽  
pp. 605-609 ◽  
Author(s):  
Tomokatsu Hori ◽  
Kimiyoshi Hirakawa ◽  
Buichi Ishijima ◽  
Shinya Manaka ◽  
Takanori Fukushima ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Anterior Inferior Cerebellar Artery ◽  
Internal Auditory Meatus ◽  
Content Type ◽  
Cerebellar Artery ◽  
Fine Print

✓ The successful surgical treatment of an intrameatal aneurysm is reported, and the signs, symptoms, and neurootological findings discussed. Anatomical consideration of the course of the anterior inferior cerebellar artery and origin of internal auditory artery are emphasized.

Microvascular anatomy of foramen caecum medullae oblongatae

1991 ◽  
Vol 75 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Asim Mahmood ◽  
Manuel Dujovny ◽  
Maximo Torche ◽  
Ljubisa Dragovic ◽  
James I. Ausman
Keyword(s):  
Vertebral Artery ◽  
Basilar Artery ◽  
Foramen Magnum ◽  
Left Vertebral Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Outer Diameter ◽  
Vertebrobasilar Insufficiency ◽  
High Concentration ◽  
Content Type ◽  
Fine Print

✓ The foramen caecum (FC) is a triangular-shaped fossa situated in the midline on the base of the brain stem, at the pontomedullary junction. Although this area is known to have a very high concentration of brainstem perforating vessels, its microvascular anatomy has not been studied in detail. The purpose of this study was to detail the microvasculature of this territory. Twenty unfixed brains were injected with silicone rubber solution and dissected under a microscope equipped with a camera. The origin, course, outer diameter, and branching pattern of the perforators were examined. The total number of perforators found in the 20 brains was 287, with an average (± standard deviation) of 14.35 ± 1.24 perforators per brain (range seven to 28). Their origin was as follows: right vertebral artery in 52 perforators (18.11%); left vertebral artery in 35 (12.19%); basilar artery below the anterior inferior cerebellar artery (AICA) in 139 (48.43%); basilar artery above the AICA in 46 (16.02%); AICA in 10 (3.48%); and anterior spinal artery in five (1.74%). Most of the perforators arose as sub-branches of larger trunks; their average outer diameter was 0.16 ± 0.006 mm while that of trunks was 0.35 ± 0.02 mm. These anatomical data are important for those wishing 1) to study the pathophysiology of vascular insults to this area caused by atheromas, thrombi, and emboli; 2) to plan vertebrobasilar aneurysm surgery; 3) to plan surgery for vertebrobasilar insufficiency; and 4) to study foramen magnum neoplasms.

Rupture of posterior inferior cerebellar artery aneurysm into the subarachnoid space during angiography

1975 ◽  
Vol 42 (4) ◽  
pp. 469-472 ◽  
Author(s):  
Amil James Gerlock
Keyword(s):  
Subarachnoid Space ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Content Type ◽  
Aneurysmal Rupture ◽  
Cerebellar Artery ◽  
Fine Print

✓ The author reports a case of angiographically-demonstrated aneurysmal rupture, and reviews related reports.

Cerebral aspergillosis

1973 ◽  
Vol 38 (4) ◽  
pp. 472-476 ◽  
Author(s):  
Pongsakdi Visudhiphan ◽  
Sira Bunyaratavej ◽  
Suwarindr Khantanaphar
Keyword(s):  
Brain Abscess ◽  
Intracranial Hemorrhage ◽  
Basilar Artery ◽  
Artery Aneurysm ◽  
Diagnosis And Treatment ◽  
Content Type ◽  
Basilar Artery Aneurysm ◽  
Fine Print

✓ Three patients with cerebral aspergillosis are reported. Each patient had a different lesion: a solitary brain abscess, a mycotic basilar artery aneurysm, and a massive infective intracranial hemorrhage. Aspergillosis is discussed, including its diagnosis and treatment.

Persistent hypoglossal artery associated with superior cerebellar artery aneurysm

1974 ◽  
Vol 40 (3) ◽  
pp. 397-399 ◽  
Author(s):  
Thomas D. Springer ◽  
Gerald Fishbone ◽  
Robert Shapiro
Keyword(s):  
Artery Aneurysm ◽  
Superior Cerebellar Artery ◽  
Content Type ◽  
Persistent Hypoglossal Artery ◽  
Hypoglossal Artery ◽  
Selective Catheterization ◽  
Cerebellar Artery ◽  
Fine Print

✓ An aneurysm at the origin of the superior cerebellar artery in a patient with a primitive hypoglossal artery is reported. Selective catheterization of the primitive artery is described with a brief discussion of the embryogenesis of carotid-basilar anastomoses. Associated findings in previously reported cases of persistent hypoglossal artery are briefly reviewed.

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