A Ruptured Distal Posterior Inferior Cerebellar Aneurysm Our Case and Review of the Literature
Hiroshima Journal of Medical Sciences Volume 51 Issue 4
Page 93-96
published_at 2002-10
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Title ( eng ) |
A Ruptured Distal Posterior Inferior Cerebellar Aneurysm Our Case and Review of the Literature
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Creator |
Nabika Shinya
Oki Shuichi
Migita Keisuke
Isobe Naoyuki
Watanabe Yosuke
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Contributors | 国立情報学研究所 |
Source Title |
Hiroshima Journal of Medical Sciences
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Volume | 51 |
Issue | 4 |
Start Page | 93 |
End Page | 96 |
Journal Identifire |
[PISSN] 0018-2052
[EISSN] 2433-7668
[NCID] AA00664312
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Abstract |
We present a case of ruptured distal posterior inferior cerebellar artery (PICA) aneurysm, and review the literature and discuss the treatment strategy. A 77-year-old woman presented with the sudden onset of severe headache, nausea and vomiting. Computed tomography revealed an intraventricular hemorrhage, predominantly in the fourth ventricle and hydrocephalus with a thin subarachinoid hemorrhage (SAH). Angiography revealed an aneurysm arising at the turning point of the vessel, from the telovelotonsillar segment of the right PICA. On the 17 day after the onset, repeated angiography revealed a smaller aneurysm than the one detected on the first day at the same place and with no spasm. On the 22 day, the aneurysm was proved to be partially thrombosed and was safely clipped via a right lateral suboccipital approach. SAH with a fourth ventricular hemorrhage or an isolated fourth ventricle hemorrhage should raise the suspicion of a distal PICA aneurysm. Aneurysms of the distal PICA have often been reported to arise at a turning point of the artery rather than at a junction of the vessel. It is suggested that the pathogenesis could be hemodynamic stress that has developed due to embryological factors. Distal PICA aneurysms have often gone detected in many previous cases because of thrombosis inside the aneurysms. Thus, particularly in the case of intentionally delayed surgery, we recommend repeated angiography under various conditions to identify how the aneurysm develops just before surgery.
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Keywords |
Distal posterior inferior cerebellar artery
Aneurysm
Thrombosis
Angiography
Aneurysm at the turning point of the vessel
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NDC |
Medical sciences [ 490 ]
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Language |
eng
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Resource Type | departmental bulletin paper |
Publisher |
Hiroshima University Medical Press
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Date of Issued | 2002-10 |
Publish Type | Version of Record |
Access Rights | open access |
Date |
[Created] 2006-03-21
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Source Identifier |
[ISSN] 0018-2052
[NCID] AA00664312
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