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.

Fatal traumatic vertebral artery aneurysm rupture

1998 ◽  
Vol 89 (5) ◽  
pp. 822-824 ◽  
Author(s):  
Ramesh L. Sahjpaul ◽  
Muwaffak M. Abdulhak ◽  
Charles G. Drake ◽  
Robert R. Hammond
Keyword(s):  
Vertebral Artery ◽  
Head Trauma ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Aneurysm Rupture ◽  
Left Vertebral Artery ◽  
Content Type ◽  
Brainstem Reflex ◽  
Cerebellar Artery ◽  
Posterior Circulation Aneurysm

✓ The authors present the case of a 34-year-old man struck over the left mastoid region by a hockey puck, who suffered a fatal rupture of a left vertebral artery berry aneurysm. He became apneic within seconds of the injury and had no brainstem reflex within minutes. The postmortem examination showed massive subarachnoid hemorrhage in the posterior fossa and the remnants of a berry aneurysm near the intradural origin of the left vertebral artery, 11 mm proximal to the posterior inferior cerebellar artery. Rupture of a saccular aneurysm as a result of head trauma is rare. This is the first reported case of a posterior circulation aneurysm rupture as a result of head trauma.

scholarly journals Progressive enlargement of a previously coiled posterior inferior cerebellar artery aneurysm

2015 ◽  
Author(s):  
Michael Karsy ◽  
Aaron Cutler ◽  
Christian Bowers ◽  
Richard Schmidt
Keyword(s):  
Relevant Literature ◽  
Multidisciplinary Treatment ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Left Vertebral Artery ◽  
Endovascular Coiling ◽  
Ct Angiogram ◽  
Cerebellar Artery

Multidisciplinary treatment of cerebral aneurysms includes endovascular coiling and open neurosurgical clipping techniques, however our understanding of long-term outcomes after coiling of large cerebral aneurysms remains limited. We present a case involving the development of a previously coiled posterior inferior cerebellar artery (PICA) aneurysm in a 64-year-old man with lesion enlargement and symptomatic mass effect. CT angiogram demonstrated a 3.9×2.6×2.4-cm partially thrombosed aneurysm adjacent to the left vertebral artery. The patient underwent resection to relieve the compressive effect. We discuss the efficacy of endovascular coiling and surgical clipping in this case as well as review the relevant literature.

scholarly journals Progressive enlargement of a previously coiled posterior inferior cerebellar artery aneurysm

2015 ◽  
Author(s):  
Michael Karsy ◽  
Aaron Cutler ◽  
Christian Bowers ◽  
Richard Schmidt
Keyword(s):  
Relevant Literature ◽  
Multidisciplinary Treatment ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebral Aneurysms ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Left Vertebral Artery ◽  
Endovascular Coiling ◽  
Ct Angiogram ◽  
Cerebellar Artery

Multidisciplinary treatment of cerebral aneurysms includes endovascular coiling and open neurosurgical clipping techniques, however our understanding of long-term outcomes after coiling of large cerebral aneurysms remains limited. We present a case involving the development of a previously coiled posterior inferior cerebellar artery (PICA) aneurysm in a 64-year-old man with lesion enlargement and symptomatic mass effect. CT angiogram demonstrated a 3.9×2.6×2.4-cm partially thrombosed aneurysm adjacent to the left vertebral artery. The patient underwent resection to relieve the compressive effect. We discuss the efficacy of endovascular coiling and surgical clipping in this case as well as review the relevant literature.

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.

Posterior inferior to posterior inferior cerebellar artery anastomosis combined with trapping for vertebral artery aneurysm

1990 ◽  
Vol 73 (3) ◽  
pp. 462-465 ◽  
Author(s):  
James I. Ausman ◽  
Fernando G. Diaz ◽  
Sean Mullan ◽  
Randy Gehring ◽  
Balaji Sadasivan ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Artery Ligation ◽  
Content Type ◽  
Cerebellar Artery ◽  
Vertebrobasilar Junction ◽  
Vertebral Aneurysm ◽  
The Right ◽  
Fine Print

✓ A case is presented in which a giant intracranial vertebral artery aneurysm gave rise to an associated ipsilateral posterior inferior cerebellar artery (PICA) from its waist. Proximal vertebral artery ligation at C-1 was achieved. The aneurysm filled from the opposite vertebrobasilar junction. Direct intracranial trapping of the right vertebral aneurysm was followed by successful anastomosis of the proximally sectioned right PICA to the adjacent left PICA in an end-to-end fashion.

Reconstruction of the posterior inferior cerebellar artery in the treatment of giant aneurysms

1996 ◽  
Vol 85 (3) ◽  
pp. 496-499 ◽  
Author(s):  
Jun-Ichiro Hamada ◽  
Shinji Nagahiro ◽  
Chikara Mimata ◽  
Takayuki Kaku ◽  
Yukitaka Ushio
Keyword(s):  
Vertebral Artery ◽  
Fourth Ventricle ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Temporal Artery ◽  
Aneurysm Surgery ◽  
Content Type ◽  
Giant Aneurysms ◽  
Cerebellar Artery ◽  
Normal Blood Flow

✓ Two techniques of revascularizing the posterior inferior cerebellar artery (PICA) during aneurysm surgery are presented. One involves transposition of the PICA to the vertebral artery proximal to the aneurysm using a superior temporal artery (STA) as a graft. This is used in cases in which the PICA has branched off from the wall of the giant vertebral artery aneurysm. The other technique involves end-to-end anastomosis of the PICA after excision of a giant distal PICA aneurysm located at the cranial loop near the roof of the fourth ventricle. The reconstructions of the PICA described here are surgical procedures designed to preserve normal blood flow in the PICA in patients treated for giant aneurysms involving that artery.

Vertebral artery section for treating arterial compression of the medulla oblongata

1993 ◽  
Vol 79 (1) ◽  
pp. 116-118 ◽  
Author(s):  
Kazuhiro Hongo ◽  
Shigeaki Kobayashi ◽  
Masanobu Hokama ◽  
Kenichiro Sugita
Keyword(s):  
Vertebral Artery ◽  
Medulla Oblongata ◽  
Pyramidal Tract ◽  
Posterior Inferior Cerebellar Artery ◽  
Term Effect ◽  
Left Vertebral Artery ◽  
Content Type ◽  
Long Term Effect ◽  
Cerebellar Artery

✓ A case of a 30-year-old man who showed progressive pyramidal tract signs caused by compression of the left vertebral artery is presented. Initial decompression of the vertebral artery by placing a piece of sponge between the artery and medulla had no long-term effect. The left vertebral artery distal to the origin of the posterior inferior cerebellar artery was then sectioned, decompressing the medulla oblongata. The patient's symptoms improved postoperatively. This is the first reported case of brain-stem compression by an elongated vertebral artery treated by sectioning of the artery.

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