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Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection
BACKGROUND: Subarachnoid hemorrhage (SAH) due to rupture of basilar artery dissection (BAD) is extremely rare and often has a poor prognosis. Since ruptured BAD has high rate of rebleeding and mortality, treatment to prevent rerupture is mandatory in the acute phase. However, to date, no optimal tre...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533090/ https://www.ncbi.nlm.nih.gov/pubmed/33024594 http://dx.doi.org/10.25259/SNI_402_2020 |
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author | Hirano, Yudai Ono, Hideaki Inoue, Tomohiro Aono, Toshiya Tanishima, Takeo Tamura, Akira Saito, Isamu |
author_facet | Hirano, Yudai Ono, Hideaki Inoue, Tomohiro Aono, Toshiya Tanishima, Takeo Tamura, Akira Saito, Isamu |
author_sort | Hirano, Yudai |
collection | PubMed |
description | BACKGROUND: Subarachnoid hemorrhage (SAH) due to rupture of basilar artery dissection (BAD) is extremely rare and often has a poor prognosis. Since ruptured BAD has high rate of rebleeding and mortality, treatment to prevent rerupture is mandatory in the acute phase. However, to date, no optimal treatment has been established which satisfies secure prevention of rerupture and ischemia simultaneously. Herein, we report a case of SAH due to BAD treated with proximal occlusion of basilar artery with superficial temporal artery (STA)-superior cerebellar artery (SCA) bypass, preventing rebleeding securely and ensuring adequate blood flow in the upper basilar region. CASE DESCRIPTION: A 48-year-old male presenting with headache and altered mental status was found to have SAH and BAD. To prevent rerupture, proximal occlusion of basilar artery with STA-SCA bypass using anterior transpetrosal approach was performed. The postoperative course was relatively good and there is no evidence of recurrent arterial dissection. CONCLUSION: Proximal occlusion of the basilar artery combined with STA-SCA bypass was successful in preventing rerupture of BAD and ensuring blood flow in the upper basilar region. Although there is controversy regarding acute treatment for ruptured BAD, direct proximal occlusion with sufficient revascularization using bypass skull base technique may be one of the optimal treatments even in this era of endovascular treatment. |
format | Online Article Text |
id | pubmed-7533090 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-75330902020-10-05 Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection Hirano, Yudai Ono, Hideaki Inoue, Tomohiro Aono, Toshiya Tanishima, Takeo Tamura, Akira Saito, Isamu Surg Neurol Int Case Report BACKGROUND: Subarachnoid hemorrhage (SAH) due to rupture of basilar artery dissection (BAD) is extremely rare and often has a poor prognosis. Since ruptured BAD has high rate of rebleeding and mortality, treatment to prevent rerupture is mandatory in the acute phase. However, to date, no optimal treatment has been established which satisfies secure prevention of rerupture and ischemia simultaneously. Herein, we report a case of SAH due to BAD treated with proximal occlusion of basilar artery with superficial temporal artery (STA)-superior cerebellar artery (SCA) bypass, preventing rebleeding securely and ensuring adequate blood flow in the upper basilar region. CASE DESCRIPTION: A 48-year-old male presenting with headache and altered mental status was found to have SAH and BAD. To prevent rerupture, proximal occlusion of basilar artery with STA-SCA bypass using anterior transpetrosal approach was performed. The postoperative course was relatively good and there is no evidence of recurrent arterial dissection. CONCLUSION: Proximal occlusion of the basilar artery combined with STA-SCA bypass was successful in preventing rerupture of BAD and ensuring blood flow in the upper basilar region. Although there is controversy regarding acute treatment for ruptured BAD, direct proximal occlusion with sufficient revascularization using bypass skull base technique may be one of the optimal treatments even in this era of endovascular treatment. Scientific Scholar 2020-08-21 /pmc/articles/PMC7533090/ /pubmed/33024594 http://dx.doi.org/10.25259/SNI_402_2020 Text en Copyright: © 2020 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 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 Hirano, Yudai Ono, Hideaki Inoue, Tomohiro Aono, Toshiya Tanishima, Takeo Tamura, Akira Saito, Isamu Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
title | Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
title_full | Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
title_fullStr | Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
title_full_unstemmed | Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
title_short | Superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
title_sort | superficial temporal artery-superior cerebellar artery bypass and proximal occlusion through anterior petrosal approach for subarachnoid hemorrhage due to basilar artery dissection |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533090/ https://www.ncbi.nlm.nih.gov/pubmed/33024594 http://dx.doi.org/10.25259/SNI_402_2020 |
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