scholarly journals Development of Unusual Collateral Channel From the Posterior Meningeal Artery After Endovascular Proximal Occlusion of the Posterior Inferior Cerebellar Artery

2007 ◽  
Vol 47 (11) ◽  
pp. 503-505 ◽  
Author(s):  
Masanori TSUTSUMI ◽  
Kiyoshi KAZEKAWA ◽  
Hiroshi AIKAWA ◽  
Minoru IKO ◽  
Tomonobu KODAMA ◽  
...  
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Cerebellar Artery ◽  
Collateral Channel ◽  
Posterior Meningeal Artery ◽  
Proximal Occlusion ◽  
Meningeal Artery

POSTERIOR INFERIOR CEREBELLAR ARTERY ORIGIN THROMBOSIS WITH ANEURYSM OF COLLATERALIZED POSTERIOR MENINGEAL ARTERY PRESENTING AS SUBARACHNOID HEMORRHAGE

Neurosurgery ◽  
2009 ◽  
Vol 65 (4) ◽  
pp. E818-E819 ◽  
Author(s):  
Steven W. Chang ◽  
Udaya K. Kakarla ◽  
Giriraj K. Sharma ◽  
Robert F. Spetzler
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Lateral Approach ◽  
Neurological Deficits ◽  
Collateral Flow ◽  
Collateral Branch ◽  
Cerebellar Artery ◽  
Far Lateral Approach ◽  
Posterior Meningeal Artery ◽  
Meningeal Artery

Abstract OBJECTIVE This is the first report of a ruptured aneurysm involving a collateral branch to the posterior inferior cerebellar artery (PICA) in a patient who had a subarachnoid hemorrhage. CLINICAL PRESENTATION A 56-year-old man initially presented with a subarachnoid hemorrhage and underwent 2 catheter-based 4-vessel angiograms with negative results. A delayed angiogram 4 weeks later revealed a dissecting aneurysm of the posterior meningeal artery, a branch of the vertebral artery. INTERVENTION A 3-dimensional reconstruction of the vertebral angiogram showed proximal occlusion of the proximal left PICA and distal filling via a collateral branch from the posterior meningeal artery. A far-lateral approach was used for this patient. The aneurysm was found along the course of the collateral posterior meningeal artery and was clipped successfully. CONCLUSION Aneurysms involving collateral branches of the PICA are rare. It is important to recognize such collateral flow preoperatively because inadvertent sacrifice of these vessels during a surgical approach could lead to stroke and neurological deficits of the PICA territory.

scholarly journals Treatment of Dissecting Vertebral Aneurysm

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 155-160 ◽  
Author(s):  
Y. Kai ◽  
J. Hamada ◽  
M. Morioka ◽  
T. Todaka ◽  
T. Mizuno ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Dissecting Aneurysm ◽  
The Other ◽  
Cerebellar Artery ◽  
Retrograde Filling ◽  
Angiographic Evidence ◽  
Vertebral Aneurysm ◽  
Proximal Occlusion ◽  
Dissecting Aneurysms

We report 17 patients with dissecting aneurysm of the vertebral artery (VA) who were treated by direct surgery (n=8) or interventional surgery (n=9). Eight patients presented with subarachnoid hemorrhage (SAH) and nine with ischemia. Ten patients were treated by trapping of the aneurysm that was occlusion of the VA on both sides of aneurysm (direct surgery, n=2; interventional surgery, n=8). The other seven patients were treated by ligation of the VA proximal to the aneurysm (direct surgery, n=6; interventional surgery, n=1). Two patients underwent transposition of the posterior inferior cerebellar artery (PICA). In 15 patients, there were no major complications. Two patients who had been treated by proximal occlusion of the VA developed rebleeding and ischemia due to persistent retrograde filling of the dissecting site. We suggest that angiographic evidence of retrograde filling of the dissecting site should have been considered as an indication for trapping. Trapping of VA dissecting aneurysms is easier and safer by interventional surgery than by direct surgery.

Operative nuances of an occipital artery to posterior inferior cerebellar artery bypass

2009 ◽  
Vol 26 (5) ◽  
pp. E19 ◽  
Author(s):  
R. Webster Crowley ◽  
Ricky Medel ◽  
Aaron S. Dumont
Keyword(s):  
Artery Bypass ◽  
Posterior Inferior Cerebellar Artery ◽  
Occipital Artery ◽  
Complex Aneurysms ◽  
Cerebellar Artery ◽  
Proximal Occlusion ◽  
Attention To Detail

Occipital artery to posterior inferior cerebellar artery bypasses remain an important tool for cerebrovascular neurosurgeons, particularly in the management of complex aneurysms of the posterior inferior cerebellar artery requiring proximal occlusion or trapping. The procedure requires meticulous technique and attention to detail. The authors outline their technique for accomplishing this bypass emphasizing nuances for complication avoidance.

Abstract 1122‐000148: Rare Anterior Inferior Cerebellar Artery Origin of Middle Meningeal Artery

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Samer Abdul Kareem ◽  
Arsalan Anwar ◽  
Nicholas Liaw ◽  
Mustafa Kareem ◽  
Osama Zaidat
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Middle Meningeal Artery ◽  
External Carotid ◽  
Anterior Inferior Cerebellar Artery ◽  
Subdural Hemorrhage ◽  
Maxillary Artery ◽  
Term Care ◽  
Anatomical Variant ◽  
Cerebellar Artery ◽  
Meningeal Artery

Introduction : Middle meningeal artery (MMA) anatomy has very important surgical implications during endovascular and open based skull procedures. Various anatomical origins have been identified in the literature besides its most common origin as the largest branch of the maxillary artery. It runs parallel and close contact of the lateral skull face therefore during trauma to this area is prone to rupture resulting in subdural hemorrhage(SDH). In our case report, we present its peculiar origin from anterior inferior cerebellar artery which has never been reported before. The origin of MMA may reflects the risk involved with embolization therapy for chronic SDH. Methods : A case of MMA originated form AICA. A literature review was conducted of reports of MMA origins. Results : A 35‐year‐old male with a history of alcohol abuse presented to the ED after falling down from the stairs. In the ED, the patient had multiple episodes of seizures along with respiratory distress therefore was intubated due to concern of airway protection. CT head showed bilateral SDH. Patient underwent diagnostic angiogram for possible bilateral embolization of MMA. During the procedure, the left MMA origin was seen from the AICA whereas the right MMA arising from the external carotid artery. Embolization of the left MMA was aborted. Patient remained intubated and was later transferred to a long term care facility. Conclusions : In the last 80 years, the anatomy of the MMA has been part of the discussion of various literature. Seeger et.al, highlighted the embryological changes manifested as anastomosis between Sphenomaxillary artery and lateral pontine artery resulting in origin of MMA from Basilar artery along with absence of foramen spinosum. Since 1973, multiple literature highlighted the origin of MMA including the lacrimal artery, ICA, ascending pharyngeal artery, opthalmic and occipital arteries. Recently, In 2011 Kuruvuilla et.al showed the origin of MMA from posterior inferior cerebellar artery. MMA clinical significance can be seen in multiple diseases. Older populations with chronic subdural hematomas, embolization of MMA has shown to be a less invasive and cost effective procedure. In patients with anterior and middle cranial fossa meningiomas embolization of MMA has been a crucial part of management. Similarly, understanding of its anatomy is also important while treating MMA aneurysm or pseudoaneurysms. In our case, the origin of middle meningeal artery from AICA has been significant as it supplies the posterior fossa structures and was not reported in the literature before, hence the procedure was aborted. This anatomical variant has shown us a new light upon embryological evolution and has helped us widen the horizons of our approach towards brain vasculature. This finding will help the future Interventionists to develop new ways of embolization of the MMA and understanding its anatomy.

Endovascular treatment for ruptured vertebral dissecting aneurysms involving PICA: Reconstruction or deconstruction? Experience from 16 patients

2020 ◽  
pp. 159101992097003
Author(s):  
Xiangjie Kong ◽  
Zeyu Sun ◽  
Chenhan Ling ◽  
Liang Xu ◽  
Cong Qian ◽  
...  
Keyword(s):  
Posterior Inferior Cerebellar Artery ◽  
Artery Occlusion ◽  
Parent Artery ◽  
First Line ◽  
Optimal Method ◽  
Parent Artery Occlusion ◽  
Cerebellar Artery ◽  
Proximal Occlusion ◽  
Dissecting Aneurysms

Objective Ruptured vertebral dissecting aneurysms (VDAs) with posterior inferior cerebellar artery (PICA) involved require an optimal method to isolate the dissection and prevent the symptomatic infraction. This study aims to present our experience with both parent artery occlusion (PAO) and stent-assisted coiling (SAC), and provide a favorable strategy to the management of ruptured VDAs with PICA involved. Methods We retrospectively reviewed patients with subarachnoid hemorrhage in our database from March 2013 to December 2018, suffering from dissecting aneurysms of the intradural vertebral arteries and endovascularly treated. A total of 16 cases with PICA involved were included. Basic information, aneurysm characteristics, procedure related complications and outcomes of patients were analyzed. Results 10 (62.5%) aneurysms were managed with PAO containing 3 proximal occlusion and 8 targeted-trapping preserved the PICA. 5 (31.3%) aneurysms were treated with SAC and one 6.3%) treated with vertebral artery to PICA stenting and trapping. Two (12.5%) patients died in the acute phase. Good clinical outcomes (modified Rankin Scale 0 to 3) were observed in 13(81.5%) cases in 30 days follow-up. PICA territory infraction was happened in one patient without any dysfunction. Favorable occlusion was observed in 9 of 12 (75%) which were free of further treatment. Conclusions For patients with good contralateral circulation, PAO could be a first line management for ruptured VDAs with PICA involved. Targeted-trapping with either reserved PICA or proximal occlusion with moderate coiling in aneurysm are promising modalities to prevent severe PICA infraction.

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