Commentary: Reimplantation Bypass Using One Limb of a Double-Origin Posterior Inferior Cerebellar Artery for Treatment of a Ruptured Fusiform Aneurysm: Case Report

2020 ◽  
Vol 19 (3) ◽  
pp. E320-E321
Author(s):  
Robert C Rennert ◽  
Jonathan J Russin
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Fusiform Aneurysm ◽  
Cerebellar Artery ◽  
Double Origin

scholarly journals Treating a Ruptured Fusiform Aneurysm of the Posterior Inferior Cerebellar Artery (PICA) using PICA-PICA Anastomosis combined with Trapping: A Case Report

2010 ◽  
Vol 19 (5) ◽  
pp. 420-424
Author(s):  
Kenta Aso ◽  
Yoshitaka Kubo ◽  
Shunsuke Kakino ◽  
Hiroshi Kashimura ◽  
Atsushi Sugawara ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Fusiform Aneurysm ◽  
Pica Pica ◽  
Cerebellar Artery

Double Origin of the Posterior Inferior Cerebellar Artery: Anatomic Case Report

2019 ◽  
Vol 124 ◽  
pp. 110-115 ◽  
Author(s):  
Ali Tayebi Meybodi ◽  
Leandro Borba Moreira ◽  
Xiaochun Zhao ◽  
Michael T. Lawton ◽  
Mark C. Preul
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Double Origin

scholarly journals Endovascular treatment for aneurysm on double origin of the posterior inferior cerebellar artery: Case report

Nosotchu ◽  
2008 ◽  
Vol 30 (3) ◽  
pp. 521-525 ◽  
Author(s):  
Kentaro Horiguchi ◽  
Eiichi Kobayashi ◽  
Takashi Saegusa ◽  
Yoshinori Ozawa ◽  
Naokatsu Saeki
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Double Origin

Surgical Treatment of a Double Origin Posterior Inferior Cerebellar Artery Aneurysm and Insights From Embryology: Case Report and Literature Review

2017 ◽  
Vol 13 (3) ◽  
pp. E8-E12 ◽  
Author(s):  
Michael A. Silva ◽  
Alfred P. See ◽  
Mohammad A. Aziz-Sultan ◽  
Nirav J. Patel
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Clinical Presentation ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Cerebellar Artery ◽  
Flow Through ◽  
Open Surgical Treatment ◽  
Double Origin ◽  
Insight Into

Abstract BACKGROUND AND IMPORTANCE: Aneurysms affecting double origin (DO) posterior inferior cerebellar artery (PICA) variants are rare. Most reports describe endovascular occlusion of the affected branch to treat the aneurysm, but we describe a patient in which open surgical sacrifice of 1 branch resulted in insufficient perfusion. This case and our review of PICA embryology provide insight into treatment of aneurysms affecting duplicated intracranial vessels. CLINICAL PRESENTATION: We report the only case of open surgical treatment of an aneurysm affecting a leg of a DOPICA. A 42-year-old woman presenting with the worst headache of her life was found to have a DOPICA aneurysm and initially treated by trapping the aneurysm. Intraoperative indocyanine green imaging revealed insufficient perfusion through the caudal branch, which was remediated by end-to-end anastomosis to preserve flow through both origins. The patient made a full recovery. CONCLUSION: Treating a DOPICA aneurysm by sacrificing 1 of the origins is not possible for all patients. This first report of open surgical treatment of a DOPICA leg aneurysm suggests that 1 or both branches may be required for sufficient perfusion, and the unique embryology of DOPICA development suggests a possible mechanism.

Reimplantation Bypass Using One Limb of a Double-Origin Posterior Inferior Cerebellar Artery for Treatment of a Ruptured Fusiform Aneurysm: Case Report

2020 ◽  
Vol 19 (3) ◽  
pp. E314-E319 ◽  
Author(s):  
Michael J Lang ◽  
Joshua S Catapano ◽  
Gabriella M Paisan ◽  
Stefan W Koester ◽  
Tyler S Cole ◽  
...  
Keyword(s):  
Case Report ◽  
Scale Score ◽  
Clinical Presentation ◽  
Posterior Inferior Cerebellar Artery ◽  
Pica Pica ◽  
Fisher Grade ◽  
Cerebellar Artery ◽  
Pica Aneurysms ◽  
Double Origin ◽  
Variant Anatomy

Abstract BACKGROUND AND IMPORTANCE Posterior inferior cerebellar artery (PICA) aneurysms are uncommon, and aneurysms associated with anatomical PICA variants are even rarer. Although often treated endovascularly, aneurysms associated with anatomical PICA variants may not be suitable for endovascular intervention because of the risk of compromise of brainstem perforators and may be more amenable to open techniques. This case report describes the successful treatment of an aneurysm associated with a double-origin PICA (DOPICA) by distally reimplanting one of the PICA limbs. CLINICAL PRESENTATION A 78-yr-old man with a Hunt-Hess grade III, Fisher grade IV subarachnoid hemorrhage secondary to a ruptured distal right PICA aneurysm associated with a DOPICA was treated with PICA-PICA bypass and trapping of the aneurysm. This is the first reported case in the literature of successful bypass of a DOPICA-associated aneurysm. Radiographically, the bypass remained patent with successful obliteration of the aneurysm, and at discharge from the hospital, the patient had a Glasgow Coma Scale score of 15 and modified Rankin Scale score of 3. CONCLUSION This case demonstrates a novel reimplantation bypass for a ruptured aneurysm that exploits this rare variant anatomy of a DOPICA.

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