Document Detail


Ruptured saccular aneurysm of distal vertebral artery fenestration managed with Guglielmi detachable coils and intraventricular tissue plasminogen activator.
MedLine Citation:
PMID:  15734513     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aneurysms associated with vertebrobasilar fenestrations are uncommon. We report on an unusual presentation of such aneurysm with a dedicated arterial pedicle, manifesting with significant intraventricular hemorrhage. Equally important, the aneurysm was managed in a multidisciplinary fashion, which, we think, greatly contributed to a good outcome. CASE DESCRIPTION: A 55-year-old man presented in good condition after subarachnoid and massive intraventricular hemorrhage. The aneurysm location and the extent of intraventricular hemorrhage both presented concerns regarding treatment approach. The aneurysm was first treated with transarterial coil obliteration, and intraventricular tissue plasminogen activator (tPA) infusion was given, with rapid resolution of evolving hydrocephalus. The patient had an excellent outcome. CONCLUSION: To our knowledge, this is the first report of a vertebrobasilar fenestration saccular aneurysm with a dedicated pedicle projecting toward the foramen of Magendie with significant intraventricular hemorrhage. In addition, this patient was successfully managed with endovascular obliteration and intraventricular tPA infusion.
Authors:
Michiya Kubo; Lotfi Hacein-Bey; Panayiotis N Varelas; John L Ulmer; Denise M Lemke; Joseph F Cusick
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  63     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-28     Completed Date:  2005-04-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-8; discussion 248     Citation Subset:  IM    
Affiliation:
Division of Neuroradiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Ruptured / radiography,  therapy*
Cerebral Angiography
Fourth Ventricle / radiography
Humans
Hydrocephalus / etiology
Injections, Intraventricular
Intracranial Aneurysm / complications,  radiography,  surgery*
Male
Middle Aged
Neurosurgical Procedures / instrumentation*,  methods
Postoperative Complications
Prostheses and Implants
Subarachnoid Hemorrhage / drug therapy,  etiology,  radiography
Tissue Plasminogen Activator / administration & dosage*
Tomography, X-Ray Computed
Treatment Outcome
Vascular Surgical Procedures / instrumentation*,  methods
Vertebral Artery / abnormalities,  radiography,  surgery*
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator

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


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