Dissecting Aneurysm in the Proximal Region of the Posterior Inferior Cerebellar Artery Presenting as Wallenberg''s Syndrome —Case Report—

Mizushima, Hidekatsu; Sasaki, Ken; Kunii, Norihiko; Nishino, Takeshi; Jinbo, Hiroyuki; Abe, Takashi; Shimazu, Motohiko; Matsumoto, Kiyoshi

doi:10.2176/nmc.34.307

Cited by 25 publications

(9 citation statements)

References 7 publications

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“…In patients with ischemic symptoms, some authors performed proximal occlusion of the parent artery [75,95], trapping with bypass [99], resection and bypass [61], encasement [25], or circumferential wrapping [107] with good postoperative recovery. Other surgeons are inclined to treat the patients conservatively [159,167].…”

Section: Ischemic Groupmentioning

confidence: 99%

State-of-art in surgical treatment of dissecting posterior circulation intracranial aneurysms

Balik

Yamada

Talari³

et al. 2016

Neurosurg Rev

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Vertebrobasilar (VB) intracranial dissecting aneurysms (IDAs) pose difficult therapeutic issues and are especially among the most difficult to manage surgically. There are, however, some cases where selective aneurysm obliteration by endovascular approach is impossible or is associated with an unacceptable risk of morbidity. This is particularly true when the aneurysm is dissecting, giant, or has a large neck. In such cases, surgical treatment may be the only alternative. Optimal management of these lesions is therefore challenging and treatment decisions have to be made on a case-by-case basis. Ideal treatment should be a complete surgical excision of the lesion; however, this procedure might only be possible after distal and proximal vessel wall occlusion which might not be tolerated by the patient depending on the location of the aneurysm. Therefore, formulation of recommendations concerning the surgical strategy remains still difficult due to inconsistency of surgical outcomes. The literature describing surgical strategy of VB IDAs is varying in quality and content, and many studies deal with only a few patients. In the presented review, the authors summarize the current knowledge on the incidence, pathogenesis, clinical presentation, and diagnostic procedures with special emphasis on surgical treatment of IDAs in posterior circulation.

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Section: Ischemic Groupmentioning

confidence: 99%

State-of-art in surgical treatment of dissecting posterior circulation intracranial aneurysms

Balik

Yamada

Talari³

et al. 2016

Neurosurg Rev

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“…Follow-up evaluation was achieved during a median period of 3 months (IQR 3-12 months) in 24 of the 28 patients (86%). The median value of the mRS score was 0 (IQR 0-1) [4,6,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] . One case developed subsequent SAH, which was fatal [14] .…”

Section: Literature Reviewmentioning

confidence: 99%

Isolated Posterior Inferior Cerebellar Artery Dissection as a Cause of Ischemic Stroke: Clinical Features and Prognosis

Kobayashi¹,

Ohara²,

Shiozawa³

et al. 2015

Cerebrovasc Dis

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Background: The purpose of this study was to clarify the incidence, clinical and radiological features and outcomes of isolated posterior inferior cerebellar artery (PICA) dissection in isolated PICA territory infarctions. Methods: We retrospectively reviewed consecutive inpatients with ischemic stroke secondary to isolated PICA dissection from our stroke database between January 2004 and December 2013 and reviewed the literature with regard to those patients. Results: Of 167 consecutive patients with an isolated PICA territory infarction, a total of 10 patients (6.0%, 3 women, 48.1 ± 7.1 years) were diagnosed as having an isolated PICA dissection. Patients with PICA dissection were younger (p < 0.001), more commonly experienced headache at onset (p = 0.008), less commonly had hyperlipidemia (p = 0.044) and showed a lower modified Rankin Scale score at discharge (p = 0.002) when compared with patients without arterial dissection. In 6 of these 10 patients, PICA dissections had not been suspected on initial magnetic resonance angiography (MRA) and were confirmed by follow-up MRA or digital subtraction angiography. In the follow-up period (median 1.5 years, interquartile range 0.5-6.3 years), there were no recurrent ischemic or hemorrhagic stroke events. Conclusions: Isolated PICA dissection as an etiological mechanism in isolated PICA territory infarctions may be more common than was previously recognized to be. The diagnosis of PICA dissection is often difficult and requires close and repeated morphological evaluation. We should carefully identify PICA dissections as a possible cause of PICA territory infarctions.

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“…Most of these cases lead to either a subarachnoid hemorrhage (SAH) or a cerebellar/brainstem infarction. [1][2][3][4][5][6][7][8][9][10] We report our experience with a VA dissection followed by spontaneous ipsilateral PICA dissection.…”

Section: Letters To Editormentioning

confidence: 99%

“…However, the welldeveloped collateral flow from AICA compensated for the compromised blood flow to the brainstem and cerebellum. [4,6] This collateral flow depends on factors such as the age and/ or the degree to which intracranial arteries have become atherosclerotic. [4,6] The main etiology of PICA dissection remains a subject of conjecture.…”

Section: Letters To Editormentioning

confidence: 99%

“…[4,6] This collateral flow depends on factors such as the age and/ or the degree to which intracranial arteries have become atherosclerotic. [4,6] The main etiology of PICA dissection remains a subject of conjecture. Spontaneous PICA dissection may have associations with giant cell arteritis, persistent primitive trigeminal artery, fenestration of both VAs, giant cerebral aneurysm at the VA-BA junction, PICA dissecting aneurysm and VA dissection at the V2-3 segment.…”

Section: Letters To Editormentioning

confidence: 99%

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A case of vertebral artery dissection associated with ipsilateral posterior inferior cerebellar artery dissection

Honda¹,

Anda²

2015

Neurol India

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Dissecting Aneurysm in the Proximal Region of the Posterior Inferior Cerebellar Artery Presenting as Wallenberg''s Syndrome —Case Report—

Cited by 25 publications

References 7 publications

State-of-art in surgical treatment of dissecting posterior circulation intracranial aneurysms

State-of-art in surgical treatment of dissecting posterior circulation intracranial aneurysms

Isolated Posterior Inferior Cerebellar Artery Dissection as a Cause of Ischemic Stroke: Clinical Features and Prognosis

A case of vertebral artery dissection associated with ipsilateral posterior inferior cerebellar artery dissection

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