Giant Serpentine Vertebrobasilar Aneurysm with Vertebral Artery Hypoplasia and Fenestration- A Case Report

Choudhary, Pradeep; Khokhar, Harsh Vardhan; Saxena, Sangeeta

doi:10.7860/jcdr/2015/11125.5645

Cited by 6 publications

(7 citation statements)

References 7 publications

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“…20 VA atresia is also associated with complex VA aneurysms. 21 However, in our series, VA atresia was not associated with a higher incidence among patients with VA-PICA aneurysms.…”

Section: Discussioncontrasting

confidence: 67%

Association between Vertebral Artery Hypoplasia and Vertebral Artery Aneurysms: A Case-Control Study

Harati

Zeh

Rohde

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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Background The aim of this retrospective case-control study was to determine the association of vertebral artery hypoplasia (VAH) and other anatomical variants with saccular vertebral artery posterior inferior cerebellar artery (VA-PICA) aneurysms. Methods The frequency of VAH, vertebral artery (VA) atresia, VA aplasia, and PICA aplasia was analyzed using computed tomography (CT) angiography in 64 patients with VA-PICA aneurysms (43 ruptured and 21 unruptured) and compared with 128 age- and sex-matched controls. Logistic regression was performed to identify independent risk factors for aneurysm formation. Results Univariate analysis showed that patients with VA-PICA aneurysms had a significantly higher frequency of VAH (53% versus 17%; odds ratio [OR] 4.8; 95% confidence interval [CI], 2.4–9.4; p < 0.0001) and VA aplasia (14% versus 1%; OR 20.8; 95% CI, 2.5–168.0; p = 0.004) compared with controls. VA-PICA aneurysms are detected significantly more often in the dominant VA, which is contralateral to VAH. Other anatomical variants are not related to aneurysm formation. Conclusions VAH and VA aplasia are potential risk factors for VA-PICA aneurysms. Altered hemodynamics caused by VAH may result in intracranial aneurysm formation. Additional research should clarify the pathophysiologic association of VAH, VA aplasia, or vascular occlusion with arteriosclerosis and intracranial aneurysm formation.

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“…20 VA atresia is also associated with complex VA aneurysms. 21 However, in our series, VA atresia was not associated with a higher incidence among patients with VA-PICA aneurysms.…”

Section: Discussioncontrasting

confidence: 67%

Association between Vertebral Artery Hypoplasia and Vertebral Artery Aneurysms: A Case-Control Study

Harati

Zeh

Rohde

et al. 2019

J Neurol Surg A Cent Eur Neurosurg

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“…However, the drawback of DSA is that the aneurysm wall is not visible 27 . The diagnostic accuracy for SA by magnetic resonance angiography (MRA) is similar to that obtained by CTA 3 , 34 .…”

Section: Imaging Examinationmentioning

confidence: 64%

“…SAs are more common in adults. Our literature review located several reported cases in children, and some of these cases may have been associated with arterial developmental abnormalities 3 .…”

Section: Introductionmentioning

confidence: 99%

Study and Therapeutic Progress on Intracranial Serpentine Aneurysms

Guo

et al. 2016

Int. J. Med. Sci.

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An intracranial serpentine aneurysm (SA) is a clinically rare entity, and very few multi-case studies on SA have been published. The present study reviewed the relevant literature available on PubMed. The studied information included the formation mechanism and natural history of SA as well as its clinical manifestation, imaging characteristics, and current treatments. After reviewing the literature, we conclude that intracranial SA can be managed surgically and by endovascular embolization, but the degree of blood flow in normal brain tissue distal to the SA must be evaluated. A balloon occlusion test (BOT) or cross compression test is recommended for this evaluation. If the collateral circulation is sufficiently compensatory, direct excision or embolization can be performed. However, if the compensatory collateral circulation is poor, a bypass surgery is necessary. Satisfactory results can be achieved in the majority of SA patients after treatment. However, the size of the aneurysm may increase in some patients after endovascular treatment. Special attention should be paid to cases exhibiting a significant mass effect to avoid subsequent SA excision due to an intolerable mass effect. Satisfactory results can be achieved with careful treatment of SA.

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“…CT angiography and MRI can be performed to screen for GSA and perfusion CT can clearly indicate the ischemic changes occurring in brain tissue around aneurysms. In this patient, MRI clearly demonstrates the mass effect, perivascular enhancement, and hypointense flow void representing the patent channel within the aneurysm [10].…”

Section: Discussionmentioning

confidence: 79%

Giant serpentine aneurysm of the internal cerebral artery and mandibular aneurysm: a case report

Deng

Feng

2019

Chin Neurosurg Jl

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Background: Giant serpentine aneurysms (GSA) originate from saccular or spindle aneurysm, dissimilar from dissected aneurysm, that are defined as partially thrombosed giant aneurysms with tortuous internal vascular channel. The clinical and neuroradiologic characteristics are clarified and the mechanism of formation and the efficacy of double stent implantation in GSA are discussed. Case presentation: An 18-year-old man presented himself with a GSA arising from the internal cerebral artery (ICA). In addition, a mandibular aneurysm (MA) arose from the external cerebral artery (ECA). Success was achieved in treating GSA through endovascular treatment with double stents implanted in the parent artery, which were LEO stent and Tubridge flow diverter. After 1 year of follow-up, three-dimensional reconstruction of blood vessels revealed the disappearance of the serpentine access of GSA, which was found to be replaced with a roughly normal vascular structure. Conclusions: Double stent implantation has provided a feasible treatment option for giant serpentine internal carotid aneurysms and eliminated the possibility of causing collateral circulation occlusion. Therefore, it represents a simple and suitable treatment method for anatomical structure and operation.

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Giant Serpentine Vertebrobasilar Aneurysm with Vertebral Artery Hypoplasia and Fenestration- A Case Report

Cited by 6 publications

References 7 publications

Association between Vertebral Artery Hypoplasia and Vertebral Artery Aneurysms: A Case-Control Study

Association between Vertebral Artery Hypoplasia and Vertebral Artery Aneurysms: A Case-Control Study

Study and Therapeutic Progress on Intracranial Serpentine Aneurysms

Giant serpentine aneurysm of the internal cerebral artery and mandibular aneurysm: a case report

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