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Treatment of vertebral artery dissecting aneurysm by aneurysm trapping and posterior inferior cerebellar artery reimplantation

Case report

Quentin J. Durward Sioux City Neurology Neurosurgery, Sioux City, Iowa

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✓ The author presents the case of a patient with a ruptured vertebral artery dissecting aneurysm in which the posterior inferior cerebellar artery (PICA) arose from the wall of the aneurysm. The aneurysm was treated by trapping and the PICA was anastomosed to the vertebral artery proximal to the dissection. This technique allows intraoperative obliteration of the aneurysm while maintaining normal blood flow to the PICA.

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  • 1.

    Aoki N, & Sakai T: Rebleeding from intracranial dissecting aneurysm in the vertebral artery. Stroke 21:16281631, 1990 Aoki N, Sakai T: Rebleeding from intracranial dissecting aneurysm in the vertebral artery. Stroke 21:1628–1631, 1990

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  • 2.

    Berger MS, & Wilson CB: Intracranial dissecting aneurysms of the posterior circulation. Report of six cases and review of the literature. J Neurosurg 61:882896, 1984 Berger MS, Wilson CB: Intracranial dissecting aneurysms of the posterior circulation. Report of six cases and review of the literature. J Neurosurg 61:882–896, 1984

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  • 3.

    Friedman AH, & Drake CG: Subarachnoid hemorrhage from intracranial dissecting aneurysm. J Neurosurg 60:325334, 1984 Friedman AH, Drake CG: Subarachnoid hemorrhage from intracranial dissecting aneurysm. J Neurosurg 60:325–334, 1984

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  • 4.

    Kitanaka C, , Morimoto T, & Sasaki T, et al: Rebleeding from vertebral artery dissection after proximal clipping. J Neurosurg 77:466468, 1992 Kitanaka C, Morimoto T, Sasaki T, et al: Rebleeding from vertebral artery dissection after proximal clipping. J Neurosurg 77:466–468, 1992

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  • 5.

    Shimoji T, , Bando K, & Nakajima K, et al: Dissecting aneurysm of the vertebral artery. Report of seven cases and angiographic findings. J Neurosurg 61:10381046, 1984 Shimoji T, Bando K, Nakajima K, et al: Dissecting aneurysm of the vertebral artery. Report of seven cases and angiographic findings. J Neurosurg 61:1038–1046, 1984

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  • 6.

    Yamada K, , Hayakawa T, & Ushio Y, et al: Therapeutic occlusion of the vertebral artery for unclippable vertebral aneurysm: relationship between site of occlusion and clinical outcome. Neurosurgery 15:834838, 1984 Yamada K, Hayakawa T, Ushio Y, et al: Therapeutic occlusion of the vertebral artery for unclippable vertebral aneurysm: relationship between site of occlusion and clinical outcome. Neurosurgery 15:834–838, 1984

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  • 7.

    Yamaura A: Diagnosis and treatment of vertebral aneurysms. J Neurosurg 69:345349, 1988 Yamaura A: Diagnosis and treatment of vertebral aneurysms. J Neurosurg 69:345–349, 1988

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  • 8.

    Yamaura A, , Watanabe Y, & Saeki N: Dissecting aneurysms of the intracranial vertebral artery. J Neurosurg 72:183188, 1990 Yamaura A, Watanabe Y, Saeki N: Dissecting aneurysms of the intracranial vertebral artery. J Neurosurg 72:183–188, 1990

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