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.

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.

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.

Treatment of vertebral artery dissecting aneurysm by aneurysm trapping and posterior inferior cerebellar artery reimplantation

1995 ◽  
Vol 82 (1) ◽  
pp. 137-139 ◽  
Author(s):  
Quentin J. Durward
Keyword(s):  
Blood Flow ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
Normal Blood ◽  
Content Type ◽  
Cerebellar Artery ◽  
Normal Blood Flow ◽  
Vertebral Artery Dissecting Aneurysm ◽  
Fine Print

✓ The author presents the case of a patient with a ruptured vertebral artery dissecting aneurysm in which the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm. The aneurysm was treated by trapping and the PICA was anastomosed to the vertebral artery proximal to the dissection. This technique allows intraoperative obliteration of the aneurysm while maintaining normal blood flow to the PICA.

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.

Vertebral artery—posterior inferior cerebellar artery bypass with a superficial temporal artery graft to treat aneurysms involving the posterior inferior cerebellar artery

2002 ◽  
Vol 96 (5) ◽  
pp. 867-871 ◽  
Author(s):  
Jun-ichiro Hamada ◽  
Tatemi Todaka ◽  
Shigetoshi Yano ◽  
Yutaka Kai ◽  
Motohiro Morioka ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Artery Bypass ◽  
Superficial Temporal Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Temporal Artery ◽  
Graft Patency ◽  
Content Type ◽  
Cerebellar Artery ◽  
Lateral Medullary Syndrome ◽  
Fine Print

Object. In patients with aneurysms that require occlusion of the posterior inferior cerebellar artery (PICA), revascularization of this artery should be performed. A novel surgical method for revascularization of the PICA is presented. Methods. After a segment of the superficial temporal artery (STA) was harvested, the aneurysm was treated by trapping, followed by placement of a vertebral artery (VA)—PICA bypass in which the STA segment was used as a graft. When the length of the proximal PICA was inadequate, the distal end of the STA was anastomosed to the proximal PICA in an end-to-side fashion. When the length of the proximal PICA was adequate, the STA was anastomosed to the proximal PICA in an end-to-end fashion. In either case, the proximal end of the STA was anastomosed to the VA in an end-to-side fashion. This procedure was used in nine patients whose aneurysms involved the PICA. Although partial lateral medullary syndrome developed in one of them, follow-up evaluation revealed graft patency in all patients. There were no instances of recurrent hemorrhage or ischemia. Conclusions. Although this procedure requires harvesting of an STA graft and two anastomoses, it facilitates anterograde flow to the PICA territory. It also involves minimal mobilization of brainstem perforating vessels and the proximal PICA.

Subarachnoid hemorrhage caused by posterior inferior cerebellar artery aneurysm with an anomalous course of the atlantoaxial segment of the vertebral artery

2005 ◽  
Vol 103 (2) ◽  
pp. 356-360 ◽  
Author(s):  
William W. Ashley ◽  
Michael R. Chicoine
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Vertebral Artery ◽  
Anatomical Variation ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Unique Case ◽  
Pertinent Literature ◽  
Content Type ◽  
Cerebellar Artery ◽  
First Time

✓ Various anatomical courses of the vertebral artery (VA) and posterior inferior cerebellar artery (PICA) have been described. The authors present a unique case of a subarachnoid hemorrhage resulting from an aneurysm in a patient with an anatomical variation of the extracranial portion of the VA and cervical origin of the PICA. The surgical implications of this variant are discussed, and the pertinent literature reviewed. Subarachnoid hemorrhage caused by rupture of a PICA aneurysm is reported for the first time in association with a rare variation of the course of the VA.

Intracranial Vertebral Endarterectomy

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 465-471 ◽  
Author(s):  
James I. Ausman ◽  
Fernando G. Diaz ◽  
Balaji Sadasivan ◽  
Manuel Dujovny
Keyword(s):  
Vertebral Artery ◽  
Medical Therapy ◽  
Superficial Temporal Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Temporal Artery ◽  
Superior Cerebellar Artery ◽  
Focal Lesion ◽  
Cerebellar Infarction ◽  
Vertebrobasilar Insufficiency ◽  
Cerebellar Artery

Abstract Intracranial vertebral endarterectomy was performed on six patients with vertebrobasilar insufficiency in whom medical therapy failed. The patients underwent operations for stenotic plaque in the intracranial vertebral artery with the opposite vertebral artery being occluded, hypoplastic, or severely stenosed. In four of the patients, the stenosis was mainly proximal to the posterior inferior cerebellar artery (PICA). In this group, after endarterectomy, the vertebral artery was patent in two patients, and their symptoms resolved: in one patient the endarterectomy occluded, but the patient's symptoms improved; and in one patient the endarterectomy was unsuccessful, and he continued to have symptoms. In one patient, the plaque was at the origin of the PICA. The operation appeared technically to be successful, but the patient developed a cerebellar infarction and died. In one patient the stenosis was distal to the PICA. During endarterectomy, the plaque was found to invade the posterior wall of the vertebral artery. The vertebral artery was ligated, and the patient developed a Wallenburg syndrome. The results of superficial temporal artery to superior cerebellar artery anastomosis are better than those for intracranial vertebral endarterectomy for patients with symptomatic intracranial vertebral artery stenosis. The use of intracranial vertebral endarterectomy should be limited to patients who have disabling symptoms despite medical therapy, a focal lesion proximal to the PICA, and a patent posterior circulation collateral or bypass.

scholarly journals Neurosurgery (Neuro Interventional)

2015 ◽  
Vol 42 (S1) ◽  
pp. S43-S44
Author(s):  
JJ Shankar ◽  
L Hodgson
Keyword(s):  
Vertebral Artery ◽  
Retrospective Analysis ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
The Third ◽  
Cerebellar Artery ◽  
Incomplete Coverage ◽  
Negative Findings ◽  
The Right

Purpose: CTA is becoming the frontline modality to reveal aneurysms in patients with SAH. However, in about 20% of SAH patients no aneurysm is found. In these cases, intra-arterial DSA is still performed. Our aim was to evaluate whether negative findings on CTA can reliably exclude aneurysms in patients with acute SAH. Materials and Method: We conducted a retrospective analysis of all DSA performed from August 2010 to July 2014 in patients with various indications. We selected patient who presented with SAH and had a negative CTA. Findings of the CTA were compared with DSA. Results: 857 DSA were performed during the study period. 51(5.95%) patients with SAH and negative findings on CTA who underwent subsequent DSA were identified. Of these, only 3(5.9%) of patients had positive findings on the DSA. One patient had a posterior inferior cerebellar artery aneurysm on the DSA, not seen on CTA due to the incomplete coverage of the head. Second patient’ CTA did not show any evidence of aneurysm. DSA showed suspicious dissection of the right vertebral artery, potentially iatrogenic. The third patient’s DSA showed suspicious tiny protuberance from left ICA, possibly infundibulum. Conclusion: In patients with SAH, negative CTA findings are reliable in ruling out aneurysms in any pattern of SAH on CT.

Posterior inferior cerebellar artery aneurysm in the fourth ventricle

1995 ◽  
Vol 37 (4) ◽  
pp. 267-269
Author(s):  
H. Urbach ◽  
B. Meyer ◽  
C. Cedzich ◽  
L. Solymosi
Keyword(s):  
Fourth Ventricle ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Cerebellar Artery

scholarly journals Posterior Inferior Cerebellar Artery Aneurysm associated with Fenestration of the Vertebral Artery

1989 ◽  
Vol 29 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Kenji ARAI ◽  
Shunro ENDO ◽  
Yutaka HIRASHIMA ◽  
Akira TAKAKU
Keyword(s):  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Cerebellar Artery
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