Endovascular Treatment of a Dissecting Posteroinferior Cerebellar Artery Aneurysm: Case Report

Lefkowitz, Michael; Teitelbaum, George P.; Giannotta, Steven L.

doi:10.1097/00006123-199611000-00031

Cited by 12 publications

(14 citation statements)

References 13 publications

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“…15 Although potentially carrying a high risk for morbidity, according to the literature and our own experience (2 patients), the risk for brain stem ischemia seems to be relatively low. 8,12,15,37 Another potential risk of permanent PICA occlusion is cerebellar ischemia distal to the occlusion site. Collateral supply from the contralateral PICA or ipsilateral anterior cerebellar artery and/or superior cerebellar artery is reported to be sufficient to prevent ischemia in most cases.…”

Section: Figmentioning

confidence: 99%

“…Despite the recently increased number of publications, the preexisting literature concerning endovascular treatment of peripheral PICA aneurysms is limited and controversial. [6][7][8][9][11][12][13][14][15][16][17][18][19][20][21] In the present study, a consecutive series of 12 patients harboring a peripheral PICA aneurysm allocated for endovascular treatment in a single center was retrospectively analyzed.…”

mentioning

confidence: 99%

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Endovascular Treatment of Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery

Isokangas¹,

Siniluoto²,

Tikkakoski³

et al. 2008

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Peripheral aneurysms of the posterior inferior cerebellar artery (PICA) are rare, and pre-existing literature concerning their endovascular treatment is limited. The purpose of this study was to assess the etiology and clinical characteristics of peripheral PICA aneurysms and to evaluate the angiographic and clinical results of the patients who underwent endovascular treatment for a peripheral PICA aneurysm in a single center.

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Section: Figmentioning

confidence: 99%

mentioning

confidence: 99%

Endovascular Treatment of Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery

Isokangas¹,

Siniluoto²,

Tikkakoski³

et al. 2008

AJNR Am J Neuroradiol

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“…Spontaneous dissection of the posteroinferior cerebellar artery (PICA) is very rare, with only few cases reported in the literature [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15]. Clinically the dissection may cause ischemic stroke or subarachnoid hemorrhage (SAH), depending on the dissecting plane of the affected artery.…”

Section: Introductionmentioning

confidence: 99%

Dissection of the Posteroinferior Cerebellar Artery: Clinical Characteristics and Long-Term Follow-Up in Five Cases

Sédat

Chau²,

Mahagne³

et al. 2007

Cerebrovasc Dis

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Background and Purpose: Spontaneous isolated posteroinferior cerebellar artery (PICA) dissection is very rare. The aim of the study was to investigate the clinical manifestations, the neuroradiological aspects and the treatment of 5 cases collected in 5 years. Methods and Results: From 1999 to 2003, five patients (40–71 years old) were hospitalized for PICA dissection. Two patients presented symptoms after cervical manipulation. No predisposing factor or traumatic cause was described in the other cases. The diagnosis was carried out by cerebral angiography in all the cases: in 4, angiography showed focal stenosis with saccular or fusiform dilatation of the artery at the site of the dissection; in 1 a double lumen aspect was described. One patient presented ischemic manifestations; he was treated with heparin. The others presented subarachnoid hemorrhage (SAH) and were treated by embolization (endovascular sacrifice of the PICA). No ischemic complication and no rebleeding were observed after sacrifice of the PICA. Three patients presented acute hydrocephalus and were treated with surgical derivation. The angiographic and clinical follow-up lasted more than 3 years. We assessed the long-term results with the Glasgow Outcome Score and the modified Rankin Score. A good recovery was achieved for 4 patients (modified Rankin Score 0); one patient who presented SAH and who was in bad clinical state on admission had a Glasgow Outcome Score of 3 and a modified Rankin Score of 4 three years later. Conclusion: Clinical course and prognosis are variable in PICA dissections. The treatment depends on the existence of a hemorrhagic event. In the group of patients presenting SAH, endovascular treatment was safe and effective. The long-term clinical results depend mainly on the clinical status on admission.

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“…3) Recently, endovascular treatment has been proposed as an alternative to conventional surgery. [1][2][3]9,10) The outcome after therapeutic endovascular proximal occlusion of the PICA is related to the extent of distal collateral circulation. 3) Therefore, preoperative evaluation of the collateral circulation in the PICA territory is important.…”

Section: Introductionmentioning

confidence: 99%

Development of Unusual Collateral Channel From the Posterior Meningeal Artery After Endovascular Proximal Occlusion of the Posterior Inferior Cerebellar Artery -Case Report-

Tsutsumi

Kaneda

Aikawa

et al. 2007

Neurol. Med. Chir.(Tokyo)

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A 38-year-old man presented with a dissecting aneurysm of the left proximal posterior inferior cerebellar artery (PICA) manifesting as Wallenberg's syndrome. The patient was treated by endovascular occlusion of the aneurysm and parent artery. Immediately after the treatment, the PICA territory was supplied by collateral circulation via the ipsilateral anterior inferior cerebellar artery. Seven days later, endogenous revascularization of the distal PICA territory had occurred via collateral circulation from the posterior meningeal artery (PMA). This unusual collateral circulation was thought to occur through a pre-existing anastomotic channel between the primitive vessels of the PICA and the PMA during subclinical hypoperfusion of the distal PICA territory. This unusual case demonstrates the potential for delayed development of collateral circulation from the PMA to the PICA territory.

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Endovascular Treatment of a Dissecting Posteroinferior Cerebellar Artery Aneurysm: Case Report

Abstract: In patients who tolerate temporary balloon occlusion, endovascular treatment of dissecting fusiform aneurysms with platinum microembolization coils is safe and effective therapy.

Cited by 12 publications

References 13 publications

Endovascular Treatment of Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery

Endovascular Treatment of Peripheral Aneurysms of the Posterior Inferior Cerebellar Artery

Dissection of the Posteroinferior Cerebellar Artery: Clinical Characteristics and Long-Term Follow-Up in Five Cases

Development of Unusual Collateral Channel From the Posterior Meningeal Artery After Endovascular Proximal Occlusion of the Posterior Inferior Cerebellar Artery -Case Report-

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