Article ; Online: Antegrade recanalization of parent artery in proximal occlusion of distal posterior inferior cerebellar artery ruptured aneurysm: A case report.
2022 Volume 100, Issue 50, Page(s) e28260
Abstract: Rationale: Distal posterior inferior cerebellar artery (PICA) aneurysms are extremely rare. Herein, we describe a case of PICA pseudoaneurysm with proximal occlusion achieved using detachable coils, but antegrade recanalization, which showed a normal ... ...
Abstract | Rationale: Distal posterior inferior cerebellar artery (PICA) aneurysms are extremely rare. Herein, we describe a case of PICA pseudoaneurysm with proximal occlusion achieved using detachable coils, but antegrade recanalization, which showed a normal PICA configuration on follow-up angiography. Possible mechanisms of the recanalization and lesions are also discussed. Patient concerns: The patient was an 80-year-old woman with a subarachnoid hemorrhage (SAH) resulting from a distal PICA-ruptured aneurysm, initially misdiagnosed as a non-aneurysmal traumatic SAH. Diagnosis: On hospitalization day 10, the patient developed rebleeding, and brain computed tomography angiography confirmed a distal PICA pseudoaneurysm. Intervention: Endovascular coil embolization was performed. Inevitably, the proximal PICA was occluded using detachable coils, and complete occlusion of the affected PICA was confirmed on the final angiogram. Outcome: Fortunately, the patient recovered fully without any neurological sequelae. One year after the procedure, a follow-up angiography was performed, which revealed recanalization of the previously occluded PICA, with normal configuration and no visible aneurysmal dilatation. Conclusion: Even if the SAH is scanty and predominantly in the perimesencephalic cistern, performing a catheter-based angiography is essential. In the case of proximal occlusion of the parent artery without internal trapping in endovascular treatment of PICA pseudoaneurysm, follow-up examination with a short-term angiography might be crucial. |
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MeSH term(s) | Aged, 80 and over ; Aneurysm, False ; Aneurysm, Ruptured/diagnostic imaging ; Aneurysm, Ruptured/surgery ; Angiography ; Cerebellum/diagnostic imaging ; Embolization, Therapeutic ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Subarachnoid Hemorrhage/diagnostic imaging ; Subarachnoid Hemorrhage/etiology ; Subarachnoid Hemorrhage/therapy ; Treatment Outcome ; Vertebral Artery |
Language | English |
Publishing date | 2022-01-26 |
Publishing country | United States |
Document type | Case Reports ; Journal Article |
ZDB-ID | 80184-7 |
ISSN | 1536-5964 ; 0025-7974 |
ISSN (online) | 1536-5964 |
ISSN | 0025-7974 |
DOI | 10.1097/MD.0000000000028260 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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