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.

scholarly journals Use of the Coupler Microanastomotic Device for the Treatment of a Distal Posterior Inferior Cerebellar Artery Aneurysm Via Excision and End-to-End Anastomosis—A Case Report

2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Oded Goren ◽  
Raghuram Sampath ◽  
Akshal S Patel ◽  
Christoph J Griessenauer ◽  
Clemens M Schirmer ◽  
...  
Keyword(s):  
Case Report ◽  
Intracranial Aneurysms ◽  
Clinical Presentation ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Parent Vessel ◽  
First Case ◽  
Cerebellar Artery ◽  
End To End ◽  
Coupler Device

ABSTRACT BACKGROUND AND IMPORTANCE The Coupler microanastomotic device (Medical Companies Alliance, Birmingham, Alabama) aims at facilitating safe and efficient end-to-end reconstruction of the native vessel ends following resection of intracranial aneurysms. CLINICAL PRESENTATION We report the first case of the Coupler device used to treat a ruptured posterior inferior cerebellar artery (PICA) aneurysm. Following aneurysmal trapping and excision, the native parent vessel ends were connected in an end-to-end fashion. CONCLUSION The microanastomotic Coupler device is an acceptable option for end-to-end anastomosis and was successfully applied in the management of a ruptured fusiform PICA aneurysm.

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.

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

Occult posterior inferior cerebellar artery dissection requiring endovascular treatment following pediatric head trauma: case report

2021 ◽  
pp. 1-6
Author(s):  
Patrick J Grover ◽  
Lauren Harris ◽  
Ayman M Qureshi ◽  
Adam Rennie ◽  
Fergus Robertson ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Vascular Imaging ◽  
Artery Dissection ◽  
Pediatric Traumatic Brain Injury ◽  
Pediatric Head Trauma ◽  
Cerebellar Artery ◽  
Trauma Case ◽  
High Level

This is the eighth case report of a pediatric dissecting posterior inferior cerebellar artery aneurysm. The authors present the case of a 13-year-old boy who presented with posttraumatic posterior fossa subdural, subarachnoid, and intraventricular hemorrhage with hydrocephalus. Initial vascular imaging findings were negative; however, a high level of suspicion is necessary. The aneurysm was identified on day 20, after recurrence of hydrocephalus, and was treated with endovascular vessel sacrifice. The patient made a good recovery. It is important to consider arterial dissection in pediatric traumatic brain injury, especially with suspicious findings on initial CT scan and clinical presentation out of proportion to the mechanism of injury. Delayed vascular imaging is imperative for appropriate management.

Posterior inferior cerebellar artery aneurysm in the fourth ventricle: Acute surgical treatment

1981 ◽  
Vol 16 (6) ◽  
pp. 448-451 ◽  
Author(s):  
Alberto Pasqualin ◽  
Renato Da Pian ◽  
Renato Scienza ◽  
Claudio Licata
Keyword(s):  
Surgical Treatment ◽  
Fourth Ventricle ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Cerebellar Artery

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
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