Document Detail


Posterior inferior cerebellar artery aneurysms: incidence, clinical presentation, and outcome of endovascular treatment.
MedLine Citation:
PMID:  17928380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Results of endovascular treatment of PICA aneurysms are not well established. The purpose of this study was to report incidence, clinical presentation, and outcome of endovascular treatment in 46 patients with 47 posterior inferior cerebellar artery (PICA) aneurysms. MATERIALS AND METHODS: Of 2169 aneurysms treated between January 1995 and March 2007, 60 were located on the PICA (incidence, 2.8%). Forty-seven proximal PICA aneurysms in 46 patients were treated with endovascular techniques, 37 ruptured (79%) and 10 unruptured (21%). Four patients presented with lower cranial nerve palsies. Mean aneurysm size was 6.8 mm (median, 6 mm; range, 2-32 mm). Forty-three aneurysms were occluded with coils (6 including the PICA origin), and 4 were treated with proximal vertebral artery (VA) occlusion. RESULTS: Four aneurysms treated with proximal VA occlusion were not occluded. Procedural rupture occurred in 9 aneurysms leading to death in 2 patients and to permanent disability in 1 patient. One patient developed lateral medullary and cerebellar infarctions after PICA occlusion. Combined mortality and morbidity was 8.6% (4 of 46). Outcome at 6 months in 38 surviving patients was good in 35 and moderate in 3. No hemorrhage occurred during 109 patient-years of follow-up. Symptoms of mass effect resolved in all 4 patients. CONCLUSION: In our experience, PICA aneurysms were challenging lesions, prone to procedural rupture. In some instances, endovascular treatment required occlusion of the parent PICA; usually this was well tolerated. In other instances, treatment required occlusion of the VA. Although this was effective in alleviation of symptoms of mass effect, it was not effective in causing thrombosis of the aneurysm.
Authors:
J P Peluso; W J van Rooij; M Sluzewski; G N Beute; C B Majoie
Publication Detail:
Type:  Clinical Conference; Journal Article     Date:  2007-10-10
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  29     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-14     Completed Date:  2008-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  86-90     Citation Subset:  IM    
Affiliation:
Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cerebellum / blood supply*
Embolization, Therapeutic / mortality*
Female
Humans
Incidence
Intracranial Aneurysm / mortality*,  therapy*
Male
Middle Aged
Netherlands / epidemiology
Risk Assessment / methods*
Risk Factors
Survival Analysis
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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