Non-Giant Aneurysms of the Vertebral Artery: 181 Patients
The vertebral artery may give rise to saccular aneurysms throughout its intracranial course, but two-thirds occurred at the distal crotch of origin of posterior-inferior cerebellar artery (PICA). The notorious tortuosity of the vertebral artery and the varying level of origin of PICA have placed vertebral aneurysms anywhere from positions near the intracranial entry of the vertebral artery under the first dentate ligament, even in the upper lateral cervical canal, to that portion of the vertebral artery under the middle of the medulla. Right vertebral aneurysms have even been seen and operated on the left side of the midline. Most vertebral aneurysms project upward, lying shallowly on the medulla, either laterally or in front. A few project more posteriorly into the medulla, while others may have a dome adherent to the clivus. There is often an intimate relationship to the twelfth nerve, which usually lies across the upper side of the neck (Illustration 14.VIII, C), although it has been seen to be split in two by the growth of the sac and thus lie on both sides of the neck, but only seven patients had hypoglossal paresis and three of them were redoaneurysms. Peculiar to vertebral aneurysms (and superior cerebellar aneurysms) is for PICA (or superior cerebellar artery (SCA)) to emerge more from the side of the neck than from the parent artery.
KeywordsVertebral Artery Superior Cerebellar Artery Pica Origin Pica Aneurysm Dacron Patch
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- 7.Drake CG: Management of aneurysms of the posterior circulation. In: Youmans JR (ed) Neurological surgery, 1st ed, vol 2. Philadelphia: Saunders, 1973, pp 787–806Google Scholar
- 11.Fox JL: Intracranial aneurysms, vol I-III. New York, Berlin, Heidelberg, Tokyo: Springer, 1983, pp 63–117Google Scholar
- 19.Kempe LG: Aneurysms of the vertebral artery. In: Pia HW, Langmaid C, Zierski J (eds) Cerebral aneurysms. Advances in diagnosis and therapy. Berlin, Heidelberg, New York: Springer, 1979, pp 199–120Google Scholar
- 20.Krayenbühl HA, Yaprgil MG: The cerebral arteries. In: Cerebral angiography. London: Butterworths, 1968, pp 20–84Google Scholar
- 26.Peerless SJ, Drake CG: Posterior circulation aneurysms. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. New York: McGraw-Hill, 1985, pp 1422–1437Google Scholar
- 37.Yaargil MG: Vertebrobasilar aneurysms. In: Micro-neurosurgery in 4 volumes, vol II. Stuttgart, New York: Thieme, 1986, pp 232–295Google Scholar