Endovascular treatment of basilar tip aneurysms associated with moyamoya disease

Abstract

We report the efficacy and safety of endovascular treatment of basilar tip aneurysms (BTA) in five patients with moyamoya disease. The patients underwent intra-aneurysmal embolisation with detachable platinum coils. Three BTA presented with subarachnoid haemorrhage (SAH); the other two were asymptomatic. In four cases, one embolisation procedure produced >95% angiographic obliteration of the aneurysm. In the other patient, 80-90% obliteration was achieved initially, but due to growth of the residual aneurysm, the procedure was repeated 7 months later. Two patients experienced transient oculomotor paresis as a procedure-related complication. Mean follow-up was 43.6+/-34.0 months (range 8-92 months). One patient died of putaminal haemorrhage unrelated to the aneurysm 15 months after embolisation. The other four had no subsequent SAH and survived without sequelae. Endovascular embolisation using detachable platinum coils proved to be a safe and efficient treatment modality for BTA associated with moyamoya disease.

Endovascular Treatment of Bilateral Carotid Artery Occlusion with Concurrent Basilar Apex Aneurysm: A Case Report and Literature Review

“…In this situation, the basilar artery becomes the most important artery for brain blood supply and is more prone to apex aneurysms 19-22. This condition also occurs in bilateral internal carotid artery or common carotid artery occlusion with concurrent basilar apex aneurysm, as the risk of rupture is high.…”

Imaging in children presenting with acute neurological deficit: stroke

“…The secondary collateral formation in response to the progressive stenosis and chronic cerebral hypoperfusion subsequently lead to multiple dilated vascular channels, which often involve the lenticulostriate, thalamostriate perforators and the cortico-leptomeningeal vessels 34. As these collaterals only have weak intimal walls intrinsically, they are prone to haemorrhage or small aneurysm formation 35 36. Conventional MRI sequences demonstrate loss of flow voids of the terminal ICA and its proximal branches secondary to arterial stenosis.…”

The contribution of imaging in diagnosis, preoperative assessment, and follow-up of moyamoya disease

“…These aneurysms are found either at the periphery, on the collateral dilated vessels, 11,21,46 or on the Circle of Willis, 36 most commonly on the posterior circulation. 4,6 However, when evaluating the cause of SAH in these patients, one has to also consider hemorrhage from fragile transdural anastomotic vessels. 52 In extremely rare cases, other vascular anomalies (such as arteriovenous malformations) may be detected in these patients.…”