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Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion

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...

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Autores principales: Marutani, Akiko, Nakagawa, Ichiro, Park, Hun Soo, Tamura, Kentaro, Motoyama, Yasushi, Nakase, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234302/
https://www.ncbi.nlm.nih.gov/pubmed/28144485
http://dx.doi.org/10.4103/2152-7806.196377
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author Marutani, Akiko
Nakagawa, Ichiro
Park, Hun Soo
Tamura, Kentaro
Motoyama, Yasushi
Nakase, Hiroyuki
author_facet Marutani, Akiko
Nakagawa, Ichiro
Park, Hun Soo
Tamura, Kentaro
Motoyama, Yasushi
Nakase, Hiroyuki
author_sort Marutani, Akiko
collection PubMed
description 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.
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spelling pubmed-52343022017-01-31 Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion Marutani, Akiko Nakagawa, Ichiro Park, Hun Soo Tamura, Kentaro Motoyama, Yasushi Nakase, Hiroyuki Surg Neurol Int Case Report 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. Medknow Publications & Media Pvt Ltd 2016-12-21 /pmc/articles/PMC5234302/ /pubmed/28144485 http://dx.doi.org/10.4103/2152-7806.196377 Text en Copyright: © 2016 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Marutani, Akiko
Nakagawa, Ichiro
Park, Hun Soo
Tamura, Kentaro
Motoyama, Yasushi
Nakase, Hiroyuki
Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
title Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
title_full Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
title_fullStr Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
title_full_unstemmed Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
title_short Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
title_sort ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5234302/
https://www.ncbi.nlm.nih.gov/pubmed/28144485
http://dx.doi.org/10.4103/2152-7806.196377
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