A case of basilar artery occlusion associated with unilateral low origin of the posterior inferior cerebellar artery

Ban, Masayuki; Ueta, Hiromi; Nakagawa, Yoshinobu; Matsumoto, Keizō

doi:10.1016/0090-3019(86)90264-8

Cited by 8 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 lower). 4,27 Vertebral artery dissection, once believed to be rare but now more commonly recognized, most commonly begins on the extradural V 3 segment from which a PICA may arise. 6,13,24,29 Often the dissection will progress to the dural ring and then stop, which may lead to a Wallenberg or lateral medullary syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…An extracranial-extradural origin from the vertebral artery (VA) is not rare. 4,18,21,23,28 The anatomy of the PICA with an intradural origin has been well described, but a detailed description of the PICA that originates extradurally is lacking. The PICA with an extradural origin may be encountered during a lateral suboccipital, far-lateral, or upper cervical approach.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Microsurgical anatomy of the extracranial—extradural origin of the posterior inferior cerebellar artery

Fine¹,

Cardoso²,

Rhoton³

1999

Journal of Neurosurgery

113

View full text Add to dashboard Cite

Five to 20% of PICAs have an extradural origin. In the case described, both PICAs arose extradurally from the third segment of the vertebral artery (VA). Both origins were less than 1 cm proximal to the site at which the VA penetrated the dura, and neither PICA gave rise to extradural branches. Extradurally, the PICAs coursed parallel to the VA and the C-1 nerve and the three structures penetrated the dura together. Intradurally, the PICAs remained lateral and posterior to the brainstem, whereas, in the common PICA configuration, the first segment of the PICA courses anterior to the medulla. Neither PICA sent branches to the anterior brainstem, which is commonly found in PICAs with an intradural origin. There were no soft-tissue or bone anomalies.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Microsurgical anatomy of the extracranial—extradural origin of the posterior inferior cerebellar artery

Fine¹,

Cardoso²,

Rhoton³

1999

Journal of Neurosurgery

113

View full text Add to dashboard Cite

show abstract

“…The mean length of the BA was 2.5 cm (range: 1.7 cm to 3.7 cm) in VOL. 18, NO. 7, SEPTEMBER 1990 the lateral projection.…”

Section: Radioanatomic Analysismentioning

confidence: 99%

Transcranial doppler ultrasonography versus arteriography for assessment of the vertebrobasilar circulation

Mull

Aulich

Hennerici

1990

J of Clinical Ultrasound

View full text Add to dashboard Cite

The investigation of the vertebrobasilar arterial system by transcranial Doppler (TCD) ultrasonography is difficult due to the numerous anatomical variations in the posterior circulation. To test the validity of TCD, we compared topographic measurements from vertebrobasilar angiograms and corresponding TCD findings in 58 patients with cerebrovascular diseases (N = 37, 21 affecting the vertebrobasilar system), brain tumors (N = 8), and other neurological diseases (N = 13). Normal TCD recordings of the vertebrobasilar system were confirmed by the angiograms in 25 patients, although the noninvasive method failed to separate morphologic variants (N = 15). In patients with pathological conditions of the vertebrobasilar system revealed by either method (N = 17), the combined use of both hemodynamic and radiomorphologic methods improved the diagnostic validity in 24%. We conclude that TCD examination of the posterior fossa circulation provides unambiguous results only if used in combination with cerebral arteriography.

show abstract

“…Some perforating arteries supplying the brainstem originate from the two proximal medullary segments, and there is a close relationship between the PICA proximal segment and the lower cranial nerves. There is considerable variation in the PICA origin from the VA 2,4,15) . The infrequency of PICA aneurysms, complexity of PICA anatomy, and relatively difficult surgical access make treatment of PICA aneurysms a challenge 10) .…”

Section: Discussionmentioning

confidence: 99%

Detachable Coil Embolization for Saccular Posterior Inferior Cerebellar Artery Aneurysms

Jeon

Kwon

Ahn

et al. 2009

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective : Surgical treatment of posterior inferior cerebellar artery (PICA) aneurysms is challenging due to limited surgical accessibility. Endovascular approach has a benefit of avoiding direct injury to the brainstem or lower cranial nerves. Therefore, it has recently been considered an alternative or primary modality for PICA aneurysms. We retrospectively assessed outcomes following detachable coil embolization of saccular PICA aneurysms. Methods : From February 1997 to December 2007, we performed endovascular procedures to treat 15 patients with 15 PICA aneurysms. Fourteen patients with 14 PICA aneurysms morphology of which was saccular were reviewed retrospectively. Twelve patients had ruptured aneurysms. The aneurysms arose from the PICA origin site (n = 12), the PICA lateral medullary segment (n = 1), or the PICA tonsilomedullary segment (n = 1). Results : Complete aneurysm occlusion was achieved in 10 patients, residual neck in 3, and residual sac in one. Radiological follow-up was performed in 7 patients with mean duration of 34.7 months (range, 1-97 months) and showed stable or complete occlusion in 6 patients. There were no rebleeding or retreatment after endovascular treatment. Thromboembolism was the only procedure-related complication (n = 4 ; 28.6%). Asymptomatic PICA infarction occurred in two patients and symptomatic PICA infarction in two elderly patients with poor clinical grade. Of these procedural PICA infarction cases, 1 symptomatic PICA infarction patient developed ventriculitis and septic shock leading to death. The clinical outcome was good in 10 patients (71.4%). Conclusions : In the present study, detachable coil embolization has shown as an efficient modality for PICA saccular aneurysms challenging indications of microsurgery. However, thromboembolic complications should be considered, especially in poor clinical elderly patients with ruptured aneurysms.

show abstract

A case of basilar artery occlusion associated with unilateral low origin of the posterior inferior cerebellar artery

Cited by 8 publications

References 4 publications

Microsurgical anatomy of the extracranial—extradural origin of the posterior inferior cerebellar artery

Microsurgical anatomy of the extracranial—extradural origin of the posterior inferior cerebellar artery

Transcranial doppler ultrasonography versus arteriography for assessment of the vertebrobasilar circulation

Detachable Coil Embolization for Saccular Posterior Inferior Cerebellar Artery Aneurysms

Contact Info

Product

Resources

About