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Management of a ruptured posterior inferior cerebellar artery (PICA) aneurysm with end-to-end in situ bypass: Case report.

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  • معلومة اضافية
    • المصدر:
      Publisher: Korean Society of Cerebrovascular Surgeons Country of Publication: Korea (South) NLM ID: 101589154 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2234-8565 (Print) Linking ISSN: 22348565 NLM ISO Abbreviation: J Cerebrovasc Endovasc Neurosurg Subsets: PubMed not MEDLINE
    • بيانات النشر:
      Original Publication: Seoul : Korean Society of Cerebrovascular Surgeons
    • نبذة مختصرة :
      Dissecting posterior inferior cerebellar artery (PICA) aneurysms are uncommon lesions. Their anatomy and the location of the dissection are variable, however, they usually occurs at the origin of the PICA. Dissecting PICA aneurysms generally have non-vascular morphology involving an entire segment of the artery and cannot be cut. Nevertheless, the detection of these vascular lesions has increased latterly, so it is necessary to recognize it and take the appropriate management modalities for these injuries. In this report, we describe a case of a 73-year-old male patient, who presented a history of severe headache, associated with neck stiffness, nausea, vomiting, dizziness, hypoactivity, mental confusion, and walking difficulty. Radiographic investigation with brain computed tomography (CT) showed mild bleeding in a pre-medullary and pre-pontine cistern, and cerebral angiogram showed a dissecting PICA aneurysm. Despite being a challenging treatment, microsurgery management was the chosen modality. It was performed an end-to-end anastomosis between the p2/p3 segments, showing to be effective with good clinical and radiographic outcomes. We discussed an unusual case, reviewing the current literature on clinical presentations, the angiographic characteristics of the dissecting aneurysms of PICA, and evaluating the clinical and angiographic results of patients undergoing microsurgical treatment.
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    • Contributed Indexing:
      Keywords: Cerebral aneurysm; Cerebral revascularization; Fusiform aneurysm; Subarachnoid hemorrhage
    • الموضوع:
      Date Created: 20231228 Latest Revision: 20240705
    • الموضوع:
      20250114
    • الرقم المعرف:
      PMC11220302
    • الرقم المعرف:
      10.7461/jcen.2023.E2023.05.006
    • الرقم المعرف:
      38151969