Objective: Distal posteroinferior cerebellar artery (PICA) aneurysms are rare and have not been well investigated previously. We report our series of 24 patients with 27 distal PICA aneurysms.
Methods: All patients with distal PICA aneurysms that were surgically treated at Shinshu University Hospital and its affiliated hospitals between 1983 and 2001 were reviewed retrospectively. Data relating to clinical, radiological, and intraoperative findings were analyzed.
Results: In our series, distal PICA aneurysms reached an incidence of 0.28 and 0.38% of all intracranial aneurysms and ruptured aneurysms, respectively. There were 23 ruptured and 4 unruptured distal PICA aneurysms. Of these, 74.1% were saccular, 7.4% fusiform, and 18.5% dissecting aneurysms. Primarily the telovelotonsillar segment of the PICA was affected. Usually, the surgical outcome was favorable and was influenced by the obstructive hydrocephalus and the preoperative grade. It was sometimes difficult to detect the ruptured distal PICA aneurysm on the initial angiogram, and an extracranial origin of the PICA was sometimes observed.
Conclusion: This review summarizes the presentation and outcome of a large series of 24 patients with 27 distal PICA aneurysms, and we conclude that distal PICA aneurysms are benign entities compared with vertebral artery-PICA aneurysms. Characteristics that should be considered in the treatment of distal PICA aneurysms are discussed.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1227/01.neu.0000079493.50657.1d | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Delayed Diagnosis of a Ruptured Distal Posterior Inferior Cerebellar Artery (PICA) Dissecting Aneurysm Presenting as Craniocervical Junction and Spinal Subdural Hematoma.
Cureus
October 2024
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, JPN.
Posterior inferior cerebellar artery (PICA) dissecting aneurysms are rare and typically present with subarachnoid hemorrhage (SAH) or ischemic symptoms, with a high risk of rebleeding in the acute phase. This case presents an atypical ruptured PICA aneurysm with a hematoma confined to the craniocervical junction and cervical cord, leading to a delayed diagnosis - a 41-year-old male with an atypical presentation of headache and neck pain without neurological deficits. Initial magnetic resonance imaging (MRI) revealed a hematoma extending from the craniocervical junction to the cervical spinal cord without intracranial SAH, leading to misdiagnosis as spinal subdural hematoma.
View Article and Find Full Text PDFY Reverse: Modified technique in challenging airway management.
Thorac Cancer
December 2024
Oncology, Department of Precision Medicine, Università della Campania "L. Vanvitelli", Naples, Campania, Italy.
Article Synopsis
- Self-expanding Y-metal stents (SEMS) are useful for treating complex airway lesions, but their placement can be challenging; the study introduces a modified method called the Y reverse technique to improve stent insertion.
- The research involved 15 patients with airway issues, where only those with specific conditions were treated using this new technique.
- Results showed that the Y reverse technique enhanced respiratory function, increased mean survival times, and reduced procedure duration when compared to traditional methods, indicating it to be a safe and effective treatment for airway obstruction.
Craniospinal irradiation using pencil beam Scanning: The PSI experience.
Phys Med
November 2024
Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, CH-5232 Villigen, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Radiation Oncology, University Hospital of Zürich, Zürich, Switzerland.
Article Synopsis
- The study evaluated craniospinal irradiation (CSI) treatments using protons at the Paul Scherrer Institute, focusing on local recurrences and late toxicity outcomes for 71 patients, mostly children and young adults with tumors like medulloblastoma and ependymoma.
- Data from patients treated in both prone and supine positions were analyzed, revealing that supine positioning led to lower systematic and random errors in treatment setup, resulting in more accurate dosing.
- The research concluded that local failures in treatment were not linked to inaccuracies in radiation dosing, and there was no observed correlation between treatment-related toxicities and increased radiation effects.
Risk analysis of intracranial aneurysm rupture based on the arterial segment of origin.
Front Neurol
August 2024
Department of Radiology, University of Washington, Seattle, WA, United States.
Background And Objective: The rupture risk of intracranial aneurysms (IAs) is related to their arterial origin, but whether the different segments of the artery have different risks and act as independent risk factors is still unknown. Our study aimed to investigate the rupture risk of IAs in different arterial segments in a large Chinese cohort.
Methods: Imaging and clinical data of consecutive patients with IAs diagnosed by Computed Tomography angiography (CTA) from January 2013 to December 2022 were collected.
Successful stent-assisted coil embolization for a recurrent distal posterior inferior cerebellar artery aneurysm: A case presentation.
Surg Neurol Int
July 2024
Department of Neurosurgery, Japanese Red Cross Kumamoto Hospital, Kumamoto City, Japan.
Background: Distal posterior inferior cerebellar artery (PICA) aneurysms are exceedingly rare intracranial aneurysms. In the acute phase of rupture, interventions commonly involve parent artery occlusion through endovascular treatment or direct trapping surgery. There is no consensus on the best treatment of chronic ruptured or unruptured aneurysms, and stent-assisted coil embolization has not yet been reported in the chronic phase of rupture.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!