Distal Aneurysms of Cerebellar Arteries: Incidence, Clinical Presentation, and Outcome of Endovascular Parent Vessel Occlusion

Peluso, Jo P.; Rooij, W.J. van; Sluzewski, M.; Beute, Guus

doi:10.3174/ajnr.a0607

Cited by 82 publications

(80 citation statements)

References 15 publications

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“…The former can be treated by clip ligation at the neck, and the latter may be trapped or occluded surgically or endovascularly. 6,21,24,25,[29][30][31] The etiology of the AICA aneurysm is controversial: hemodynamic stress, embryonic vulnerability, flow-related vascular pathology, and arterial dissection by local trauma or nonspecific inflammation. 29,[32][33][34][35][36][37][38][39] Our study showed that 2 aneurysms were accompanied by AVMs and Moyamoya disease.…”

Section: Discussionmentioning

confidence: 99%

“…To date, there have been reported only 17 AICA aneurysms treated by EVT, all of which were in the distal AICA and were treated by parent artery occlusion, except in 2 cases. [22][23][24][25]29,30,[40][41][42][43][44][45][46][47] The reasons for EVT in proximal AICA aneurysms may be as follows: 1) development of technologies regarding endovascular devices, 2) all treated aneurysms not fusiform but saccular, and 3) accessibility to anatomic configuration by an endovascular device. Because all the treated AICA aneurysms were saccular, it was possible to preserve the parent artery with endosaccular embolization, and stent-assisted coiling was also applied in cases of the wideneck AICA aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover in the literature review of 15 cases treated by parent artery occlusion, most of the patients also recovered well with minimal neurologic deficit. [22][23][24][25]30,42,43,[45][46][47][48][49] In view of the condition and clinical outcome of the patients, EVT may be considered a treatment option instead of surgery, despite fewer than 30 cases reported, including ours.…”

Section: Discussionmentioning

confidence: 99%

“…[22][23][24] Recently Kusaka et al 25 reported coil embolization of an AICA aneurysm with preservation of the parent artery. We present our experience in the treatment and the clinical outcome of AICA aneurysms using EVT.…”

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confidence: 99%

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Management of Anterior Inferior Cerebellar Artery Aneurysms: Endovascular Treatment and Clinical Outcome

Suh

Kim

Kim³

et al. 2010

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Management of Anterior Inferior Cerebellar Artery Aneurysms: Endovascular Treatment and Clinical Outcome

Suh

Kim

Kim³

et al. 2010

AJNR Am J Neuroradiol

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“…5,35 AICA aneurysms generally occur at the origin of this vessel at the basilar artery, but they can also occur distally at the CPA. 50 Treating these distal AICA aneurysms is challenging and generally complicated by a new-onset neurological deficit that is likely secondary to ischemia in the brainstem, middle cerebellar peduncle, or CNs. Sarkar and Link 58 reported a case of distal AICA aneurysm clipping with postsurgical increase in nystagmus and ataxia and findings on MRI of middle cerebellar peduncle stroke.…”

Section: Arterial Aneurysmsmentioning

confidence: 99%

Microvascular anatomy of the cerebellar parafloccular perforating space

Sosa

Dujovny

Onyekachi

et al. 2016

JNS

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T he surgical anatomy of the cerebellopontine angle (CPA) is complex and challenging. The cerebellopontine cistern (CPC) lies in the CPA between the brainstem, cerebellum, and petrous portion of the temporal bone and is crossed by multiple delicate nerves and small vessels directed toward the cerebellum and highly eloquent portions of the brainstem. This region often witnesses vascular pathology and tumors, leading to lengthy cerebellar retraction, dissection, and the use of bipolar coagulation that jeopardizes the integrity of cranial nerves (CNs) and cerebellar and brainstem perfusion. The cisternal surface of the middle cerebellar peduncle lateral to the cerebellar flocculus-namely, the paraflocculus or parafloccular perforating space-is particularly susceptible to the abovementioned surgical manipulation from a retrosigmoid approach, which is the workhorse approach for CPA lesions. The importance of this small but key area in the cerebellopontine interface was recognized in a classic article by David and Askenasy in the 1930s, 14 and previously published articles have described its topographic relationship to the major branches of the anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar abbreviatioNs AICA = anterior inferior cerebellar artery; CN = cranial nerve; CPA = cerebellopontine angle; CPC = cerebellopontine cistern; PICA = posterior inferior cerebellar artery; SCA = superior cerebellar artery. obJective The cerebellopontine angle is a common site for tumor growth and vascular pathologies requiring surgical manipulations that jeopardize cranial nerve integrity and cerebellar and brainstem perfusion. To date, a detailed study of vessels perforating the cisternal surface of the middle cerebellar peduncle-namely, the paraflocculus or parafloccular perforating space-has yet to be published. In this report, the perforating vessels of the anterior inferior cerebellar artery (AICA) in the parafloccular space, or on the cisternal surface of the middle cerebellar peduncle, are described to elucidate their relevance pertaining to microsurgery and the different pathologies that occur at the cerebellopontine angle. methods Fourteen cadaveric cerebellopontine cisterns (CPCs) were studied. Anatomical dissections and analysis of the perforating arteries of the AICA and posterior inferior cerebellar artery at the parafloccular space were recorded using direct visualization by surgical microscope, optical histology, and scanning electron microscope. A comprehensive review of the English-language and Spanish-language literature was also performed, and findings related to anatomy, histology, physiology, neurology, neuroradiology, microsurgery, and endovascular surgery pertaining to the cerebellar flocculus or parafloccular spaces are summarized. results A total of 298 perforating arteries were found in the dissected specimens, with a minimum of 15 to a maximum of 26 vessels per parafloccular perforating space. The average outer diameter of the cisternal portion of the perforating arteries was 0.1...

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Vascular malformations: Aneurysms and AVFs

Toledo¹,

Dashti²,

Spetzler³

2011

Pathology and Surgery Around the Vertebral Artery

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Distal Aneurysms of Cerebellar Arteries: Incidence, Clinical Presentation, and Outcome of Endovascular Parent Vessel Occlusion

Abstract: BACKGROUND AND PURPOSE:The aim of this retrospective study was to report the incidence, clinical presentation, and midterm clinical and imaging results of endovascular parent vessel occlusion of 11 patients with 13 distal cerebellar artery aneurysms.

Cited by 82 publications

References 15 publications

Management of Anterior Inferior Cerebellar Artery Aneurysms: Endovascular Treatment and Clinical Outcome

Management of Anterior Inferior Cerebellar Artery Aneurysms: Endovascular Treatment and Clinical Outcome

Microvascular anatomy of the cerebellar parafloccular perforating space

Vascular malformations: Aneurysms and AVFs

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