1. Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
- Author
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Kentaro Tamura, Yasushi Motoyama, Akiko Marutani, Hiroyuki Nakase, Hun Soo Park, and Ichiro Nakagawa
- Subjects
medicine.medical_specialty ,Subarachnoid hemorrhage ,medicine.medical_treatment ,Case Report ,hemodynamic stress ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Aneurysm ,Cerebellar hemisphere ,medicine.artery ,Internal medicine ,medicine ,cardiovascular diseases ,Hemodynamic stress ,medicine.diagnostic_test ,business.industry ,superficial temporal artery-superior cerebellar artery bypass ,neck clipping ,Clipping (medicine) ,medicine.disease ,Posterior inferior cerebellar artery ,medicine.anatomical_structure ,Distal posterior inferior cerebellar artery aneurysm ,Angiography ,Cardiology ,cardiovascular system ,Surgery ,Neurology (clinical) ,business ,Cerebellar artery ,030217 neurology & neurosurgery - Abstract
Background A distal posterior inferior cerebellar artery (PICA) de novo aneurysm at the cortical segment after atherosclerotic basilar artery occlusion is extremely rare. Here, we report the case of a ruptured distal PICA de novo aneurysm 8 years after basilar artery occlusion. Case description A 75-year-old man experienced sudden disturbance of consciousness; computed tomography demonstrated cerebellar and subarachnoid hemorrhage due to a ruptured distal PICA aneurysm. Neck clipping of the aneurysm prevented re-rupture initially, and superficial temporal artery-superior cerebellar artery (STA-SCA) bypass was performed 3 months after admission. Postoperative angiography confirmed patency of the bypass, and the patient was discharged without any new neurological deficits. Conclusion This report describes a case of de novo development of a saccular distal PICA aneurysm after atherosclerotic basilar artery occlusion. We believe that increased hemodynamic stress at the PICA might have contributed to the occurrence and rupture of the aneurysm. STA-SCA bypass, introduced in the territory of the cerebellar hemisphere, reduces hemodynamic stress, which would prevent the occurrence of de novo aneurysm and recurrent bleeding.
- Published
- 2016