Aneurysmal subarachnoid hemorrhage with concomitant posterior communicating artery fenestration

Abstract

Fenestrations of the posterior communicating artery (PCoA) are extremely rare. Associated aneurysms have only been documented three times in the literature, and none associated with a subarachnoid hemorrhage. We describe a 52-year-old female who presented with a subarachnoid hemorrhage secondary to a ruptured saccular aneurysm at the proximal limb of a fenestrated right PCoA. The patient was also found to have bilateral middle cerebral artery (MCA) aneurysms. Surgical management included surmising the etiology of the subarachnoid hemorrhage with subsequent clipping of both the right PCoA and MCA aneurysm. The potential embryological mechanisms leading to a PCoA fenestration are discussed.

Complex basilar artery fenestration aneurysm successfully treated with single flow diverter using novel “crossing flow diverter technique” – A rare case report and review of literature

“…6 Considering the difficult posterior fossa location, these lesions are preferably treated with endovascular techniques, but surgical option has also been described in literature. 6,10 Endovascular management of complex basilar artery fenestration aneurysms can be challenging especially with some of the features like large size, wide neck, and incorporation of both limbs of fenestration into the dome.…”