Persistent patent pseudolumen of ruptured dissecting aneurysm involving the posterior inferior cerebellar artery after proximal clipping

In the majority of cases of ruptured vertebral artery dissecting aneurysm after proximal clipping, the dissected pseudolumen persists for a very short time, probably because re-entry from the pseudolumen is minimal. Recent reports have indicated a high risk of rebleeding of dissecting aneurysms invo...

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Bibliographic Details
Published in:Acta neurochirurgica 1999-01, Vol.141 (5), p.533-536
Main Authors: Nakatomi, H, Nagata, K, Kawamoto, S
Format: Article
Language:English
Subjects:
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - diagnosis
Aneurysm, Dissecting - surgery
Aneurysm, Ruptured - surgery
Cerebellum - blood supply
Cerebellum - physiopathology
Cerebral Infarction - etiology
Humans
Male
Middle Aged
Postoperative Complications
Subarachnoid Hemorrhage - etiology
Subarachnoid Hemorrhage - surgery
Vertebral Artery - physiopathology
Vertebral Artery - surgery
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Description
Summary:In the majority of cases of ruptured vertebral artery dissecting aneurysm after proximal clipping, the dissected pseudolumen persists for a very short time, probably because re-entry from the pseudolumen is minimal. Recent reports have indicated a high risk of rebleeding of dissecting aneurysms involving the posterior inferior cerebellar artery (PICA) after proximal clipping, probably due to excessive retrograde flow from the distal vertebral artery into both the PICA and the pseudolumen. We describe an extremely rare case of ruptured dissecting aneurysm involving the PICA with persistent patent pseudolumen after proximal clipping. The present case was assumed to have developed a moderate retrograde flow just sufficient to maintain the patent pseudolumen in the chronic stage. Neointimal formation is suggested to be a possible mechanism by which the pseudolumen is stabilized for a very long period.
ISSN:0001-6268
0942-0940
DOI:10.1007/s007010050337