Posterior Inferior Cerebellar Artery Aneurysm: Subarachnoid Hemorrhage after a Minor Trauma, Fusiform Dissecting Aneurysm, Treatment with a p64 Flow Diverter

Living reference work entry

Abstract

A 58-year-old woman suffered a fall in the morning of January 1, 2017. A few hours later she was admitted with symptoms of disorientation and dysarthria. The CT showed an extensive subarachnoid hemorrhage (SAH) and a further CTA disclosed a peripheral aneurysm of the right posterior inferior cerebellar artery (PICA). The aneurysm was treated with a p64 flow diverter. DSA follow-up confirmed the obliteration of the aneurysm while the PICA remained patent. The patient made a complete recovery. This case illustrates the benefit of parent artery preservation and confirms previous experiences that treatment with flow diverters prevents recurrent hemorrhage from peripheral dissecting PICA aneurysms.

Keywords

PICA Dissecting aneurysm Peripheral aneurysm Flow diversion p64 Fusiform aneurysm 

References

  1. Awad AJ, Mascitelli JR, Haroun RR, De Leacy RA, Fifi JT, Mocco J. Endovascular management of fusiform aneurysms in the posterior circulation: the era of flow diversion. Neurosurg Focus. 2017;42(6):E14.  https://doi.org/10.3171/2017.3.FOCUS1748.CrossRefPubMedGoogle Scholar
  2. Cellerini M, Mangiafico S, Ammannati F, Ambrosanio G, Muto M, Galasso L, Mennonna P. Ruptured, dissecting posterior inferior cerebellar artery aneurysms: endovascular treatment without parent vessel occlusion. Neuroradiology. 2008;50(4):315–20.CrossRefGoogle Scholar
  3. Chung Y, Ryu J, Choi SK, Kim EJ, Choi JH, Lee SH. Treatment strategy for isolated posterior inferior cerebellar artery dissection. World Neurosurg. 2017;98:644–53.  https://doi.org/10.1016/j.wneu.2016.11.094.CrossRefPubMedGoogle Scholar
  4. de Barros Faria M, Castro RN, Lundquist J, Scrivano E, Ceratto R, Ferrario A, Lylyk P. The role of the pipeline embolization device for the treatment of dissecting intracranial aneurysms. AJNR Am J Neuroradiol. 2011;32(11):2192–5.  https://doi.org/10.3174/ajnr.A2671.CrossRefPubMedGoogle Scholar
  5. Lim SM, Choi IS, Hum BA, David CA. Dissecting aneurysms of the distal segment of the posterior inferior cerebellar arteries: clinical presentation and management. AJNR Am J Neuroradiol. 2010;31(6):1118–22.  https://doi.org/10.3174/ajnr.A2014.CrossRefPubMedGoogle Scholar
  6. Maimon S, Saraf-Lavi E, Rappaport ZH, Bachar G. Endovascular treatment of isolated dissecting aneurysm of the posterior inferior cerebellar artery. AJNR Am J Neuroradiol. 2006;27(3):527–32.PubMedGoogle Scholar
  7. Sedat J, Chau Y, Mahagne MH, Bourg V, Lonjon M, Paquis P. Dissection of the posteroinferior cerebellar artery: clinical characteristics and long-term follow-up in five cases. Cerebrovasc Dis. 2007;24(2–3):183–90.CrossRefGoogle Scholar
  8. Tawk RG, Bendok BR, Qureshi AI, Getch CC, Srinivasan J, Alberts M, Russell EJ, Batjer HH. Isolated dissections and dissecting aneurysms of the posterior inferior cerebellar artery: topic and literature review. Neurosurg Rev. 2003;26(3):180–7.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.GemeinschaftskrankenhausKoblenzGermany

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