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.

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 Persistent hypoglossal artery aneurysm: Case report and qualitative systematic review

2018 ◽  
Vol 25 (2) ◽  
pp. 164-171
Author(s):  
George H Tse ◽  
Andrew Martin ◽  
Richard A Dyde ◽  
Stuart C Coley
Keyword(s):  
Systematic Review ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Persistent Hypoglossal Artery ◽  
Randomised Study ◽  
Hypoglossal Artery ◽  
Qualitative Systematic Review ◽  
Cerebellar Artery ◽  
Patient Reported

A persistent hypoglossal artery was first described in 1889 and is one of the more common anatomical variations arising from aberration in normal development. Endovascular coiling has been recognised as a robust treatment for acutely ruptured intracranial arterial aneurysms, although specific data regarding an aneurysm arising from a persistent hypoglossal artery is lacking due to the low incidence. Here we report both the oldest patient reported to be treated with a persistent hypoglossal artery-associated aneurysm and also explicitly report endovascular treatment of a persistent hypoglossal artery aneurysm arising at the posterior inferior cerebellar artery origin. Qualitative systematic review of the available medical literature demonstrates limited evidence regarding treatment of persistent hypoglossal artery-associated aneurysms with the majority being carried out via open surgery. Ruptured posterior inferior cerebellar artery aneurysm arising from a persistent hypoglossal artery can be successfully and safely treated by endovascular therapy via the persistent hypoglossal artery. Randomised study of this situation is unlikely to be feasible; however, qualitative review of the literature reveals six such aneurysms that have been treated surgically, and this case appears to be the first via an endovascular means.

scholarly journals Re-Growth of a Posterior Inferior Cerebellar Artery Aneurysm after Resection of the Associated Posterior Fossa Arteriovenous Malformation

2014 ◽  
Vol 20 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Hosam Al-Jehani ◽  
Donatella Tampieri ◽  
Maria Cortes ◽  
Denis Melançon
Keyword(s):  
Arteriovenous Malformation ◽  
Posterior Fossa ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Cerebellar Artery ◽  
Long Term Follow Up ◽  
Glue Embolization

Arteriovenous malformation (AVM)-related aneurysms have been described in the literature. Their behavior varies based on their location in relation to and the activity of the shunting through the index AVM. The intuitive expectation supported by numerous reports is that these aneurysms should regress if the AVM is excluded from the circulation. We describe a case of 46-year-old man who presented with a posterior fossa AVM with an aneurysm on the posterior inferior cerebellar artery feeding the AVM. The nidus of the AVM was successfully excluded by glue embolization, with initial regression of the PICA aneurysm on serial imaging. Five years after the endovascular treatment, the aneurysm showed significant re-growth necessitating endovascular coiling. This case presents the re-growth of an AVM-related aneurysm and emphasizes the importance of long-term follow-up of such aneurysms even if the AVM is completely excluded.

scholarly journals Thrombosed Large Distal Posterior Inferior Cerebellar Artery Aneurysm Mimicking an Infratentorial Ependymoma

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Peter Yat Ming Woo ◽  
Natalie Man Wai Ko ◽  
Kwong Yau Chan
Keyword(s):  
Magnetic Resonance ◽  
Posterior Inferior Cerebellar Artery ◽  
Three Dimensional ◽  
Artery Aneurysm ◽  
Mass Effect ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Cerebellar Artery ◽  
Large Aneurysm ◽  
Permanent Neurological Deficit

Large or giant intracranial aneurysms can simulate brain tumors clinically and radiologically by virtue of their progressive mass effect. Unlike aneurysms from alternative locations, those arising from the distal posterior inferior cerebellar artery (PICA) are uncommon. We report a patient who experienced progressive hemiparesis with magnetic resonance imaging findings suggestive of an infratentorial ependymoma. Intraoperatively, a thrombosed large aneurysm of the distal PICA was unexpectedly encountered. The aneurysm was clipped and the patient did not develop any permanent neurological deficit. This case illustrates the radiological nuances of large aneurysms and infratentorial ependymomas. Three-dimensional contrast-enhanced magnetic resonance angiography can be falsely negative and the importance of the “target” sign is emphasized. One should be cognizant of this possible diagnosis for patients with midline fourth ventricular lesions in order to reduce surgical risk.

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.

Challenges in the Management of a Ruptured Bihemispheric Posterior Inferior Cerebellar Artery Aneurysm

2019 ◽  
Vol 122 ◽  
pp. 317-321 ◽  
Author(s):  
Chin Lik Tan ◽  
Gopinathan Anil ◽  
Tseng Tsai Yeo ◽  
Ning Chou
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Cerebellar Artery

Rupture of previously documented small asymptomatic saccular intracranial aneurysms

1992 ◽  
Vol 76 (6) ◽  
pp. 1019-1024 ◽  
Author(s):  
Wouter I. Schievink ◽  
David G. Piepgras ◽  
Fremont P. Wirth
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intracranial Aneurysms ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Careful Consideration ◽  
Middle Cerebral Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Cerebellar Artery ◽  
Cerebral Artery Aneurysm

✓ In a recent study from the Mayo Clinic on the natural history of intact saccular intracranial aneurysms, none of the aneurysms smaller than 10 mm in diameter ruptured. It was concluded that these aneurysms carry a negligible risk for future hemorrhage and that surgery for their repair could not be recommended. These findings and recommendations have been the subject of much controversy. The authors report three patients with previously documented asymptomatic intact saccular intracranial aneurysms smaller than 5 mm in diameter that subsequently ruptured. In Case 1, a 70-year-old man bled from a 4-mm middle cerebral artery aneurysm that had been discovered incidentally 2½ years previously during evaluation of cerebral ischemic symptoms. A 10-mm internal carotid artery aneurysm and a contralateral 4-mm middle cerebral artery aneurysm had not ruptured. Case 2 was that of a 66-year-old woman who bled from a 4-mm pericallosal aneurysm that had been present 9½ years previously when she suffered subarachnoid hemorrhage (SAH) from a 7 × 9-mm posterior inferior cerebellar artery aneurysm. Although the pericallosal aneurysm had not enlarged in the intervening years, a daughter aneurysm had developed. The third patient was a 45-year-old woman who bled from a 4- to 5-mm posterior inferior cerebellar artery aneurysm that had measured approximately 2 mm on an angiogram obtained 4 years previously; at that time she had suffered SAH due to rupture of a 5 × 12-mm posterior communicating artery aneurysm. These cases show that small asymptomatic intact saccular intracranial aneurysms are not innocuous and that careful consideration must be given to their surgical repair and long-term follow-up study.

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