Aneurysm on the Cortical Branch (P4 Segment) of the Posterior Cerebral Artery  -Case Report-

Yamahata, Hitoshi; Tokimura, Hiroshi; Hirabaru, Masashi; Hirano, Hirofumi; Arita, Kazunori

doi:10.2176/nmc.50.1084

Cited by 14 publications

(9 citation statements)

References 15 publications

(33 reference statements)

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“…Regarding the surgical approach, a transsylvian approach, subtemporal approach, and occipital interhemispheric approach are frequently employed for P1 and P2, P2 and P3, and P3 and P4, respectively. 9,10) Endovascular treatment has been increasingly reported with recent advances of microcatheter and embolization materials. 2,3,6,11) The advantages of endovascular treatment are that the lesion can be relatively easily approached and the risk of brain damage is low.…”

Section: Discussionmentioning

confidence: 99%

Intra-Aneurysmal Coil Embolization of a Ruptured Distal Posterior Inferior Temporal Artery Aneurysm: A Case Report

Kishi

Kayama

Kimura

et al. 2022

JNET

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We report a case of a ruptured aneurysm at the posterior inferior temporal artery (PITA) of the posterior cerebral artery (PCA) treated by intra-aneurysmal coil embolization.Case Presentation: A 93-year-old man presented with disturbance of consciousness. Angiography revealed a 3-mm aneurysm in the distal PITA of the left PCA. He was diagnosed with subarachnoid hemorrhage and intracerebral hemorrhage due to a ruptured aneurysm. This aneurysm was occluded by intra-aneurysmal coil embolization with preservation of the PITA. Conclusion:Distal PITA aneurysm of the PCA is rare. Complete occlusion and preservation of the parent artery were achieved by intra-aneurysmal coil embolization, which may be an effective therapeutic option for such aneurysms.

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Section: Discussionmentioning

confidence: 99%

Intra-Aneurysmal Coil Embolization of a Ruptured Distal Posterior Inferior Temporal Artery Aneurysm: A Case Report

Kishi

Kayama

Kimura

et al. 2022

JNET

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“…So far, 19 studies including ours have revealed cases of ruptured P4 aneurysms (►Table 1). [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] Moreover, 36% of the cases were treated via an occipital surgical corridor, while five out of seven occipital approaches were interhemispheric. Orita et al reported that transventricular and transhematoma approaches should be preferred over the interhemispheric one when extensive cerebral edema exists.…”

Section: Discussionmentioning

confidence: 99%

“…Studies reporting cases of ruptured distal posterior artery aneurysms[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] …”

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confidence: 99%

Distal Posterior Cerebral Artery Ruptured Aneurysm: A Rare Case Report and Review of Literature

et al. 2022

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Distal posterior cerebral artery aneurysms consist of a rare vascular entity whose treatment approach remains challenging. Few studies exist scarcely in the literature reporting cases of P4 ruptured aneurysms. In this study, we present the case of a 49-year-old female patient who was admitted to our Neurosurgery Department with the World Federation of Neurological Surgeons grade IV, Fischer grade IV subarachnoid hemorrhage due to a right distal posterior cerebral artery aneurysm. She successfully underwent surgery via a posterior occipital interhemispheric approach. The patient recovered well from surgery, and the following days, she was successfully extubated and had a significant neurological improvement. However, she died during her rehabilitation due to sepsis and severe acute respiratory distress syndrome.

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“…Accordingly, we treated both of our PCA aneurysm patients by aneurysmal coil occlusion and selective PVO, which resulted in satisfactory outcome. On the contrary, to our knowledge from the literature, patients with distal PCA were mainly treated with deliberate PVO ( 36 ), either at the level of the aneurysmal neck only ( 37 , 38 ), or when non-saccular aneurysms were encountered ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Intracranial Aneurysms on Distal Arterial Branches: Illustrative Case Series and Literature Retrospection

Rotim

Splavski

Kalousek

et al. 2020

ACC

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Intracranial aneurysms located on distal arterial branches are sporadic and scarce. They account for 2%-7% of the middle cerebral artery and 0.7%-2.3% of the posterior cerebral artery aneurysms, where they mainly arise distally from the P2-related sites. Such aneurysms usually remain asymptomatic prior to rupture, making their diagnosis and management really demanding. Endovascular treatment comprising of different neurointerventional techniques is becoming the most operational up-to-date routine to approach distal cerebral branch aneurysms. In this single-institution case series, endovascular selective coiling and/or parent vessel occlusion resulted in successful and total aneurysmal exclusion from cerebral circulation, which brought good recovery. Hereby, we present an illustrative case series of distal arterial branch intracranial aneurysms, discussing their possible etiology and various endovascular management modalities. We also provide a literature retrospection concerned with this rare entity. In conclusion, due to their predisposition for rupture, distal branch intracranial aneurysms should be treated early and aggressively. We do believe that endovascular selective coil occlusion is the management method of choice, while parent vessel occlusion (with liquid embolics) is optimal when aneurysmal coiling cannot be achieved, or when distal cortical territory is well vascularized by strong collateral cerebral circulation.

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Aneurysm on the Cortical Branch (P4 Segment) of the Posterior Cerebral Artery -Case Report-

Cited by 14 publications

References 15 publications

Intra-Aneurysmal Coil Embolization of a Ruptured Distal Posterior Inferior Temporal Artery Aneurysm: A Case Report

Intra-Aneurysmal Coil Embolization of a Ruptured Distal Posterior Inferior Temporal Artery Aneurysm: A Case Report

Distal Posterior Cerebral Artery Ruptured Aneurysm: A Rare Case Report and Review of Literature

Endovascular Management of Intracranial Aneurysms on Distal Arterial Branches: Illustrative Case Series and Literature Retrospection

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