Endovascular and Microsurgical Treatment of Superior Cerebellar Artery Aneurysms

Abstract

ObjectiveSuperior cerebellar artery (SCA) aneurysms are regarded as being as difficult to treat surgically as posterior circulation aneurysms. We describe here a series of 33 of these aneurysms treated with microsurgery or embolization.MethodsBetween June 1997 and August 2007, 33 patients (9 men, 24 women; age, 29 to 76 years) with SCA aneurysms underwent microsurgical (n = 12) or endovascular (n = 21) treatment. Twenty two patients presented with subarachnoid hemorrhage. Thirty aneurysms were located in the junction between the SCA and the basilar artery (BA), two in the proximal SCA (S1) and one in the distal SCA (S2-3).ResultsOf the 29 SCA aneurysms, located in the junction between the SCA and BA, which were available on conventional angiography, 20 were lateral-superior, six lateral-horizontal, two lateral inferior, and one posterior type. Of the 12 patients treated microsurgically, eight had clinically excellent or good outcomes. Causes of poor outcomes included initial poor clinical status (n = 2), infarction due to parent artery compromise (n = 1), and artery of Heubner injury due to surgery for a coexisting anterior communicating artery aneurysm (n = 1). Of the 21 patients treated endovascularly, 17 had clinical good or excellent outcomes. Causes of clinically poor outcomes included initial poor clinical status (n = 2) and infarction due to thrombosis of exposed coil mesh (n = 1). One patient underwent embolization resulted in death due to vasospasm. Three patients required additional embolization for coil compaction.ConclusionThere was no morbidity related to perforator injury, regardless of the treatment modality. Embolization or microsurgery is an effective modality, with relatively low procedural morbidity and mortality rates.

Endovascular treatment of superior cerebellar artery aneurysms

“…Of the 40 patients who were followed up, 6 had aneurysm remnants and 34 had complete occlusion (19). Previous studies have reported a retreatment rate of 10%-25% for SCA aneurysms (9,13,19).…”

Superior Cerebellar Artery Aneurysm: Ruptured Blister Aneurysm Treated with Balloon-Assisted Coil Occlusion with Good Angiographic and Clinical Outcome

“…4). SCA aneurysms are considered difficult lesions to treat by surgical clipping because the operative field is narrow and there are important anatomic structures nearby, namely, cranial nerves (Jin et al 2012;Sanai et al 2008). Endovascular methods, which have been increasingly used in recent years with advanced technology and ever-greater experience, have become the standard of care in many centers for the treatment of posterior circulation aneurysms.…”

Fusiform Superior Cerebellar Artery Aneurysm Treated with Endovascular Treatment

“…The distal SCA is frequently duplicated. Furthermore, good collaterals can exist between the SCA and both the AICA and PICA through the vermian arcade and also with the paramedian branches and perforators of the basilar artery 8)10). If a patent artery with total SCA occlusion is necessary, these collateral circulations must be considered.…”