Aneurysms of the Posterior Cerebral Artery: Retrospective Review of Surgical Treatment

Honda, Masaru; Tsutsumi, Keisuke; Yokoyama, Hiroaki; Yonekura, Masahiro; Nagata, Izumi

doi:10.2176/nmc.44.164

Cited by 71 publications

(53 citation statements)

References 27 publications

(17 reference statements)

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“…Compared with other intracranial aneurysms, PCA aneurysms are uncommon lesions that account only for 0.7%-2.3% of all intracranial aneurysms. 5,7,10,16,17,19 Given the low incidence of total PCA aneurysms, P 2 segment and distal PCA aneurysms are even rarer, often reported as part of a limited case series or general reviews of PCA aneurysms. Unlike other aneurysms, P 2 segment and distal aneurysms tend to be larger, serpentine, and dissecting.…”

Section: Discussion Anatomical and Clinical Featuresmentioning

confidence: 99%

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Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P2 segment and distal aneurysms

et al. 2015

JNS

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P osterior cerebral artery (PCA) aneurysms are rare lesions that account for only 0.7%-2.3% of all intracranial aneurysms. 5,7,10,16,17,19 Because fetal-type PCA is a normal variation of a PCA, with a rate of 3%-36%, 20 there is an even lower incidence of fetal-type PCA aneurysms. The term "fetal-type PCA" refers to the condition of the PCA originating directly from the posterior communicating artery (PCoA). In this case, the P 1 segment is either smaller than the PCoA or has disappeared. Before this study, fetal-type PCA aneurysms have never been reported as an individual group.Given its complicated anatomical character, surgical management of the PCA aneurysm may be of high risk for the patient and is being replaced gradually by neurointervention. For P 2 segment and distal aneurysms, it is believed that endovascular intervention yields a better clinical outabbreviatioNs BOT = balloon occlusion test; CTA = CT angiography; DSA = digital subtraction angiography; GOS = Glasgow Outcome Scale; HH = Hunt and Hess; ICA = internal carotid artery; ICH = intracerebral hematoma; IVH = intraventricular hemorrhage; MRA = MR angiography; PAO = parent artery occlusion; PCA = posterior cerebral artery; PCoA = posterior communicating artery; SAH = subarachnoid hemorrhage. submitted January 10, 2014. accepted September 18, 2014. iNclude wheN citiNg Published online March 13, 2015; DOI: 10.3171/2014.9.JNS1442. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. The following grant funded this study: Talents Project of Health Department of Zhejiang Province (no. 2011RCB022 to J. Xu). * Drs. Jing Xu and Liang Xu contributed equally to this work. obJect P 2 segment and distal aneurysms are rare lesions of the cerebrovascular system. The efficacy and safety of endovascular occlusion for these types of aneurysms remain controversial. The aim of this study was to reveal risk factors for endovascular parent artery occlusion of ruptured P 2 segment and distal aneurysms. methods Between March 2010 and November 2012, 812 patients with a ruptured intracranial aneurysm were admitted to the authors' hospital. Among them, 11 patients presented with P 2 segment and distal posterior cerebral artery (PCA) aneurysms. These patients were subjected to endovascular treatment. Periprocedural data and clinical and angiographic records were studied retrospectively. results Of the patients with a ruptured PCA aneurysm, 2 of them underwent selective aneurismal coiling, and the remaining patients were treated with simultaneous occlusion of the parent artery. Patients with an adult-type PCA (n = 6), treated with either selective coiling or simultaneous parent artery occlusion, had no serious neurological deficits on follow-up. Four patients with a fetal-type PCA that was also occluded intraoperatively exhibited newly developed permanent paralysis and hemianopsia. However, 1 patient with a fetal-type PCA aneurysm that was selectively coiled recovered witho...

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Section: Discussion Anatomical and Clinical Featuresmentioning

confidence: 99%

“…5,7,10,16,17,19 Because fetal-type PCA is a normal variation of a PCA, with a rate of 3%-36%, 20 there is an even lower incidence of fetal-type PCA aneurysms. The term "fetal-type PCA" refers to the condition of the PCA originating directly from the posterior communicating artery (PCoA).…”

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confidence: 99%

Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P2 segment and distal aneurysms

et al. 2015

JNS

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“…11,26,29) Aneurysms may occur at the proximal PCA 3,14,29) at earlier ages, 8) and tend to be associated with other aneurysms. 29) PCA aneurysms frequently become large, 5,8) so other manifestations, except for subarachnoid hemorrhage, are common.…”

Section: Discussionmentioning

confidence: 99%

“…Manifestations caused by brain stem compression, such as somnolence, amnesia, hemianopia, and cranial nerve palsy, have been reported. 3,29) The pterional 11,14) and subtemporal 11,14) approaches are ordinarily used for P 1 -P 2 aneurysms. A transchoroidal fissure approach is typically considered for high-positioned P 2 aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Coil Embolization for a Ruptured Posterior Cerebral Artery Aneurysm With Vertebrobasilar Dolichoectasia -Case Report-

Yamaguchi

Ito

Maeda

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 74-year-old man suffered sudden loss of consciousness at home. Computed tomography revealed severe subarachnoid hemorrhage and an unusual posterior cerebral artery (PCA) aneurysm with vertebrobasilar dolichoectasia (VBD). The aneurysm was located in the right hypothalamus. VBD associated with a distal lesion makes endovascular treatment difficult because of the elongation and tortuosity of the access route. However, endovascular coil embolization was successful for the present ruptured PCA aneurysm with VBD.

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“…[1][2][3] Because of this low incidence, most of the institutional series on PCA aneurysms are small 2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17] ; only 7 reports with more than 25 patients have previously been published ( Table 1). 1,[18][19][20][21][22][23] The largest series was reported by Drake et al 7 in a study of 125 cases.…”

Section: Introductionmentioning

confidence: 99%

40 Posterior Cerebral Artery Aneurysms

Goehre

Jahromi

Lehečka

et al. 2018

Decision Making in Neurovascular Disease

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Aneurysms of the Posterior Cerebral Artery: Retrospective Review of Surgical Treatment

Cited by 71 publications

References 27 publications

Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P2 segment and distal aneurysms

Fetal-type posterior cerebral artery: the pitfall of parent artery occlusion for ruptured P2 segment and distal aneurysms

Coil Embolization for a Ruptured Posterior Cerebral Artery Aneurysm With Vertebrobasilar Dolichoectasia -Case Report-

40 Posterior Cerebral Artery Aneurysms

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