Intracranial Vertebral Artery Aneurysms: Clinical Features and Outcome of 190 Patients

Lehto, Hanna; Niemelä, Mika; Kivisaari, Riku; Laakso, Aki; Jahromi, Behnam Rezai; Hijazy, Ferzat; Andrade-Barazarte, Hugo; Dashti, Reza; Hernesniemi, Juha

doi:10.1016/j.wneu.2015.03.034

Cited by 21 publications

(16 citation statements)

References 49 publications

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“…There are very few reported few cases that describe management of VBJ aneurysms in association with the AICA-PICA variant. Several neurosurgical techniques to treat VBJ aneurysms are described, such as direct clipping, wrapping, clipping with wrapping, and proximal occlusion with or without bypass [ 3 ]. However, obtaining optimal neurosurgical access is challenging because of the overlying petrous bone, and the risk of injuring perforating arteries, cranial nerves, and other vital structures close to the brainstem.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases

Phuyal

Paudel

Agrawal

et al. 2020

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases

Phuyal

Paudel

Agrawal

et al. 2020

International Journal of Surgery Case Reports

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“…They will surely be an important training tool for many neurosurgeons. [ 5 6 8 9 11 12 14 15 16 22 ]…”

Section: Discussionmentioning

confidence: 99%

The open access video collection project “Hernesniemi's 1001 and more microsurgical videos of Neurosurgery”: A legacy for educational purposes

Choque-Velasquez¹,

Kozyrev²,

Colasanti³

et al. 2017

Surg Neurol Int

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Background:Neurosurgical educational programs and courses are helpful to improve the quality of training. Moreover, nowadays, online activities may represent a very useful tool to globally enhance neurosurgical education. The “Hernesniemi's 1001 and more microneurosurgical videos” project aims to show the microsurgical style developed by the senior author and his TEAMs in more than 40 years of experience.Methods:More than 1100 high-definition videos of microneurosurgical operations performed by the senior author were carefully edited. These videos illustrate the philosophy of “simple, clean, fast and preserving the normal anatomy” while offering a step by step guide of different neurosurgical procedures.Results:All the aforementioned material is well organized in an electronic videobook, freely available in Surgical Neurology International. The book also includes comments of great current neurosurgeons and writings of the authors and editors.Conclusion:We are sure that our project will be able to instill in and spread across the neurosurgical community the microneurosurgical style of the senior author, thus representing an efficient educational tool for surgeons all around the world.

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“…[24] While typically less amenable to clipping compared to saccular aneurysms, dissecting or fusiform aneurysms, have occasionally been treated by methods such as clipping or wrapping, although these alternatives carry the risk of rebleeding. [25] The lower third of the posterior circulation can be accessed by variations of the lateral or far-lateral suboccipital approach. [33] However, these techniques are especially challenging for dissecting aneurysms that often have fusiform morphology and friable walls without an easily clippable neck, and the additional challenge of PICA involvement necessitating preservation of parent artery flow.…”

Section: Review Of Literaturementioning

confidence: 99%

Treatment of intracranial vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery origin

Chen

Garrett

Mlikotic

et al. 2019

Surgical Neurology International

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Background: Vertebral artery dissecting aneurysm (VADA) involving the origin of the posterior inferior cerebellar artery (PICA) is a complex disease entity in which the dual goals of preventing future rebleeding and maintaining perfusion of the lateral medulla must be considered. We present an illustrative case and review the literature surrounding treatment strategies. Case Description: We report a patient presenting with extensive subarachnoid hemorrhage due to rupture of an intracranial VADA involving the PICA origin. After consideration of the patient’s cerebral vasculature and robustness of collaterals, a flow-diverting stent was placed with angiographic resolution of the lesion and maintenance of antegrade PICA flow. Ultimately, the patient experienced a contralateral intraparenchymal hemorrhage leading to death. Review of the literature identified 124 cases of VADA involving the PICA origin described over the past decade. The methods of surgical and endovascular treatment of these cases were reviewed, with particular focus on the rationale of treatment, outcomes, and complications. Conclusion: Numerous treatment options for VADA involving PICA have been reported with different risk and benefit profiles. Flow-diverting stents appear to offer the most favorable balance of securing the aneurysm and avoiding medullary infarction, but the risks and optimal anti-thrombotic treatment strategy are incompletely understood. In select cases, in which the surgical risk is low or in which the anatomy is favorable (e.g., nondominant parent vessel or robust collateral circulation in the involved territories), parent artery trapping with or without microsurgical revascularization can be considered.

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Intracranial Vertebral Artery Aneurysms: Clinical Features and Outcome of 190 Patients

Cited by 21 publications

References 49 publications

Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases

Endovascular treatment of complex vertebrobasilar junction aneurysms: A report of two cases

The open access video collection project “Hernesniemi's 1001 and more microsurgical videos of Neurosurgery”: A legacy for educational purposes

Treatment of intracranial vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery origin

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