Transpositions and anastomoses between the posterior cerebral and superior cerebellar arteries

Report of two cases

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✓ Two cases are reported in which anastomotic procedures between the posterior cerebral and superior cerebellar arteries were useful for the management of occlusive and aneurysmal disease of the posterior circulation. Operative procedures such as these may play a role in the future management of vascular problems in this system.

Article Information

Address reprint requests to: Thoralf M. Sundt, Jr., M.D., Cerebral Vascular Research Center, Alfred Building, Room 4–437, St. Mary's Hospital, Rochester, Minnesota 55901.

© AANS, except where prohibited by US copyright law.

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Figures

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    Preoperative angiogram of a large posterior cerebral artery aneurysm in which the parent vessel is incorporated into the base of the aneurysm. The aneurysm had a thick wall at its base, and it was not possible to clip the aneurysm without having the clip displaced onto the parent vessel.

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    Postoperative angiogram demonstrating good filling of the posterior cerebral artery from the point of anastomosis in the superior cerebellar artery. The parent posterior cerebral artery has been occluded with a miniature Mayfield clip just proximal to the origin of the aneurysm. Major perforating vessels to the brain-stem structures arose from the posterior cerebral artery proximal to the site of clipping and were preserved.

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    Operative sketch demonstrating the essentials of the operative procedure.

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    Postoperative angiogram demonstrating patency at the site of anastomosis between the posterior cerebral artery and the proximal superior cerebellar artery. Occlusion time for this anastomosis was 30 minutes. The procedure was tolerated without neurological complications.

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    Operative sketch demonstrating the essentials of side-to-side anastomosis between a fetal-type posterior cerebral artery and a superior cerebellar artery.

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