Document Detail

The true distal posterior inferior cerebellar artery aneurysm: clinical characteristics and strategy for treatment.
MedLine Citation:
PMID:  20376738     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: A series of aneurysms located at the 4 (th) or 5 (th) segment of the posterior inferior cerebellar artery (PICA) has not been previously reported in the literature. We report six such cases and analyze their clinical characteristics and outcomes from three different treatment strategies. MATERIAL AND METHODS: We reviewed six patients with a diagnosis of distal PICA aneurysm. The following data were analyzed: age, sex, aneurysm size, Hunt-Hess grade at presentation, angiographic characteristics, and clinical treatment outcome determined by Glascow outcome scores (GOS). Treatments performed included clipping and wrapping, sacrificing the parent arteries of the aneurysms, and selective coiling. RESULTS: Six patients (5 females, 1 male; mean age: 61.2 years; mean aneurysm size: 6.2 mm) presented at our facility with subarachnoid hemorrhage (SAH) caused by aneurysm rupture. Two patients presented with Hunt-Hess grades 4 and 5; all others were in Hunt-Hess grades 2 or 3. One patient died before surgery. Treatment outcomes of the surviving five patients were as follows: three patients had GOS of 5, one improved by operation, and another died from re-bleeding after selective coiling. CONCLUSION: Surgery for the true distal PICA aneurysm results in good clinical outcomes. Clipping or wrapping should be considered as the first choice for treatment, and sacrificing the parent artery of the distal PICA aneurysm is relatively safer than selective coiling. The type of parent artery and particularly the collateralization of its distal part should be considered as an essential factor to take into consideration when choosing a treatment strategy.
Y Zhou; Y Kato; O T Olugbenga; S Hirotoshi; K Karagiozov; O Masahiro; S Amitendu; N Makoto; K Tetsuo
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Publication Detail:
Type:  Journal Article     Date:  2010-04-07
Journal Detail:
Title:  Minimally invasive neurosurgery : MIN     Volume:  53     ISSN:  1439-2291     ISO Abbreviation:  Minim Invasive Neurosurg     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440973     Medline TA:  Minim Invasive Neurosurg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  9-14     Citation Subset:  IM    
Copyright Information:
(c) Georg Thieme Verlag KG Stuttgart . New York.
Department of Neurosurgery, Xiehe Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China.
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MeSH Terms
Aged, 80 and over
Aneurysm, Ruptured / diagnosis*,  mortality,  surgery*
Arteries / surgery
Cerebellum / blood supply*
Cerebral Angiography
Embolization, Therapeutic
Glasgow Outcome Scale
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Intracranial Aneurysm / diagnosis*,  mortality,  surgery*
Magnetic Resonance Imaging
Middle Aged
Subarachnoid Hemorrhage / diagnosis*,  mortality,  surgery*
Surgical Instruments
Survival Analysis
Tomography, X-Ray Computed

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