Spontaneous thrombosis of posterior cerebral artery aneurysm with angiographic reappearance

1993 ◽  
Vol 79 (3) ◽  
pp. 434-437 ◽  
Author(s):  
John L. D. Atkinson ◽  
John I. Lane ◽  
Harold J. Colbassani ◽  
D. Mark E. Llewellyn
Keyword(s):  
Mr Imaging ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Brain Infarction ◽  
Artery Aneurysm ◽  
Parent Vessel ◽  
Spontaneous Thrombosis ◽  
Vessel Occlusion ◽  
Content Type ◽  
Parent Vessel Occlusion

✓ The case is presented of a 23-year-old man suffering ischemic brain infarction from spontaneous thrombosis of a left posterior cerebral artery P1–P2 junction aneurysm. Vasospasm and/or partial parent vessel occlusion were documented by magnetic resonance (MR) imaging and angiography. Repeat cerebral angiography and MR imaging 3 months later revealed patency of the posterior cerebral artery and luminal filling of a 1-cm fusiform aneurysm, which was successfully trapped at surgery.

Traumatic dissecting pathology of posterior cerebral artery: a report of two cases—aneurysm and pial arteriovenous fistula

2021 ◽  
Vol 14 (5) ◽  
pp. e237722
Author(s):  
Vignesh Selvamurugan ◽  
Surya Nandan Prasad ◽  
Vivek Singh ◽  
Zafar Neyaz
Keyword(s):  
Arteriovenous Fistula ◽  
Cerebral Artery ◽  
Road Traffic ◽  
Posterior Cerebral Artery ◽  
Case Reports ◽  
Dissecting Aneurysm ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Parent Vessel Occlusion ◽  
Pial Arteriovenous Fistula

We present two cases of 17-year-old man and 10-year-old boy presenting with subarachnoid haemorrhage and a history of road traffic accident. One patient had dissecting aneurysm of the posterior cerebral artery (PCA), and the other patient had partially thrombosed aneurysm on CT angiography. On digital subtraction angiography of the second patient, there was formation of PCA pontomesencephalic vein pial arteriovenous fistula (PAVF). Both the patients underwent endovascular treatment: stent-assisted coiling for aneurysm and coiling with parent vessel occlusion for PAVF. There were no procedural complications. Follow-up angiography showed no residual aneurysm or fistula. Trauma is one of the recognised causes of dissection, and intracranial dissections can present as stenotic lesions, aneurysms or fistulas, depending on the pathology. Traumatic dissecting PCA aneurysm has been reported in only two case reports previously, and post-traumatic PAVF in PCA has not been reported.

Parent vessel occlusion for P2 dissecting aneurysms of the posterior cerebral artery

2009 ◽  
Vol 71 (3) ◽  
pp. 319-325 ◽  
Author(s):  
Xianli Lv ◽  
Youxiang Li ◽  
Chuhan Jiang ◽  
Xinjian Yang ◽  
Zhongxue Wu
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Parent Vessel Occlusion ◽  
Dissecting Aneurysms

GIANT FUSIFORM ANEURYSM ARISING FROM FENESTRATED POSTERIOR CEREBRAL ARTERY AND BASILAR TIP VARIATION

Neurosurgery ◽  
2009 ◽  
Vol 64 (3) ◽  
pp. E564-E565 ◽  
Author(s):  
Marco A. Zanini ◽  
Vitor M. Pereira ◽  
Mauricio Jory ◽  
José G.M.P. Caldas
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Superior Cerebellar Artery ◽  
Fusiform Aneurysm ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Cerebellar Artery ◽  
Parent Vessel Occlusion ◽  
The Right ◽  
Double Origin

Abstract OBJECTIVE A giant fusiform aneurysm in the posterior cerebral artery (PCA) is rare, as is fenestration of the PCA and basilar apex variation. We describe the angiographic and surgical findings of a giant fusiform aneurysm in the P1–P2 PCA segment associated with PCA bilateral fenestration and superior cerebellar artery double origin. CLINICAL PRESENTATION A 26-year-old woman presented with a 2-month history of visual blurring. Digital subtraction angiography showed a giant (2.5 cm) fusiform PCA aneurysm in the right P1–P2 segment. The 3-dimensional view showed a caudal fusion pattern from the upper portion of the basilar artery associated with a bilateral long fenestration of the P1 and P2 segments and superior cerebellar artery double origin. INTERVENTION Surgical trapping of the right P1–P2 segment, including the posterior communicating artery, was performed by a pretemporal approach. Angiograms performed 3 and 13 months after surgery showed complete aneurysm exclusion, and the PCA was permeated and filled the PCA territory. Clinical follow-up at 14 months showed the patient with no deficits and a return to normal life. CONCLUSION To our knowledge, this is the first report of a giant fusiform aneurysm of the PCA associated with P1–P2 segment fenestration and other variations of the basilar apex (bilateral superior cerebellar artery duplication and caudal fusion). Comprehension of the embryology and anatomy of the PCA and its related vessels and branches is fundamental to the decision-making process for a PCA aneurysm, especially when parent vessel occlusion is planned.

Posterior Cerebral Artery Aneurysms: Parent Vessel Occlusion Being a Viable Option in the Era of Flowdivertors

2020 ◽  
Vol 68 (2) ◽  
pp. 316
Author(s):  
Vivek Singh ◽  
RajendraVishnu Phadke ◽  
Vivek Agarwal ◽  
Sanjay Behari ◽  
Zafar Neyaz ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Viable Option ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Parent Vessel Occlusion

Potential proneness of fetal-type posterior cerebral artery to vascular insufficiency in parent vessel occlusion of distal posterior cerebral artery aneurysms

2012 ◽  
Vol 117 (2) ◽  
pp. 284-287 ◽  
Author(s):  
Xianli Lv ◽  
Youxiang Li ◽  
Xinjian Yang ◽  
Chuhan Jiang ◽  
Zhongxue Wu
Keyword(s):  
Cerebral Artery ◽  
Collateral Circulation ◽  
Posterior Cerebral Artery ◽  
Parent Artery ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Adult Type ◽  
Coil Occlusion ◽  
Vascular Insufficiency ◽  
Parent Vessel Occlusion

Object The purpose of this study was to report the potential proneness of a fetal-type posterior cerebral artery (PCA) to develop vascular insufficiency in parent vessel occlusion of distal PCA aneurysms. Methods Between January 2005 and January 2011, 19 patients (9 females and 10 males) with 20 distal PCA aneurysms (16 dissecting and 4 saccular) were treated with endovascular parent vessel occlusion. The ages of the patients ranged from 5 to 71 years, with a mean age of 40.2 years. Of the 20 aneurysms, 4 were ruptured and 16 were unruptured. One of the unruptured aneurysms was additional to another ruptured aneurysm, and 15 were incidentally discovered. Five aneurysms were smaller than 10 mm, and the other 15 were 10 mm or larger. Results All aneurysms were successfully treated with simultaneous coil occlusion of the aneurysm and the parent PCA. One patient had hemianopia at the initial presentation, and 2 patients had new persistent hemianopia due to insufficient leptomeningeal collateral circulation; in 16 patients with an intact visual field, no hemianopia developed because there was sufficient leptomeningeal collateral circulation. A fetal-type PCA was involved in all 3 patients with hemianopia, which was initially presented or caused by parent vessel occlusion. However, in the patients without hemianopia, an adult-type PCA was involved in all cases. Conclusions Endovascular treatment via coil occlusion of the aneurysm as well as the parent artery can be used to cure distal PCA aneurysms. A fetal-type PCA could be an important predictive factor for vascular insufficiency in parent vessel occlusion treatment.

Routine intraoperative angiography during aneurysm surgery

2002 ◽  
Vol 96 (6) ◽  
pp. 988-992 ◽  
Author(s):  
Veronica L. Chiang ◽  
Phillipe Gailloud ◽  
Kieran J. Murphy ◽  
Daniele Rigamonti ◽  
Rafael J. Tamargo
Keyword(s):  
Surgical Treatment ◽  
False Negative ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Intraoperative Angiography ◽  
Content Type ◽  
Negative Results ◽  
Parent Vessel Occlusion ◽  
Fine Print

Object. The routine use of intraoperative angiography as an aid in the surgical treatment of aneurysms is uncommon. The advantages of the ability to visualize residual aneurysm or unintended occlusion of parent vessels intraoperatively must be weighed against the complications associated with repeated angiography and prolonged vascular access. The authors reviewed the results of their routine use of intraoperative angiography to determine its safety and efficacy. Methods. Prospectively gathered data from all aneurysm cases treated surgically between January 1996 and June 2000 were reviewed. A total of 303 operations were performed in 284 patients with aneurysms; 24 patients also underwent postoperative angiography. Findings on intraoperative angiographic studies prompted reexploration and clip readjustment in 37 (11%) of the 337 aneurysms clipped. Angiography revealed parent vessel occlusion in 10 cases (3%), residual aneurysm in 22 cases (6.5%), and both residual lesion and parent vessel occlusion in five cases (1.5%). When compared with subsequent postoperative imaging, false-negative results were found on two intraoperative angiograms (8.3%) and a false-positive result was found on one (4.2%). Postoperative angiograms obtained in both false-negative cases revealed residual anterior communicating artery aneurysms. Both of these aneurysms also subsequently rebled, requiring reoperation. In the group that underwent intraoperative angiography, in 303 operations eight patients (2.6%) suffered complications, of which only one was neurological. Conclusions. In the surgical treatment of intracranial aneurysms, the use of routine intraoperative angiography is safe and helpful in a significant number of cases, although it does not replace careful intraoperative inspection of the surgical field.

scholarly journals Treatment outcomes in cerebral artery dissection and literature review

2018 ◽  
Vol 24 (3) ◽  
pp. 254-262 ◽  
Author(s):  
Karanarak Urasyanandana ◽  
Dittapong Songsang ◽  
Taweesak Aurboonyawat ◽  
Ekawut Chankaew ◽  
Pattarawit Withayasuk ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Functional Outcomes ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Parent Artery ◽  
Parent Vessel ◽  
Vessel Occlusion ◽  
Parent Vessel Occlusion ◽  
Internal Carotid Arteries ◽  
Spontaneous Dissection

Methods Patients with cerebral artery dissections were reviewed in a hospital setting from 2008 to 2015. Clinical presentations, lesion locations, treatment modalities, functional outcomes, and mortality were reviewed. Parent artery occlusion was the first choice for surgery or endovascular treatment of a hemorrhagic dissecting cerebral artery. Endovascular or surgical reconstructive treatment was indicated in patients whose parent artery could not be occluded. Favorable functional outcomes were determined using modified Rankin Scale (mRS) scores of 0–2. Results In total, 61 patients with cerebral artery dissections were admitted to the hospital. Seven (11.5%) had traumatic dissections. All traumatic dissections were located in the internal carotid arteries. Overall favorable outcome rate was about 57% (4/7). Spontaneous cerebral artery dissections were found in 54 patients. No difference in favorable outcomes was observed between parent vessel occlusion and selective occlusion with parent vessel preservation (or vessel reconstruction) (70% and 63%, respectively, p = 1.000). Patients who presented with spontaneous dissection without intracranial hemorrhage had more favorable outcomes than those with intracranial hemorrhage (79% and 52%, respectively, p = 0.045). The mortality rate of patients with spontaneous dissection was 7.4%. Conclusions Most of the traumatic dissections were located on the internal carotid arteries and spontaneous dissections were commonly located on vertebral arteries. Nonhemorrhagic spontaneous cerebral dissections had better functional outcomes after treatment. Endovascular and surgical management were effective treatments by parent vessel occlusion or reconstructions.

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