Article Figures & Data
Figures
- Fig 1.
A 28-year-old man (patient 4) had serious head trauma from motor vehicle crash. A, The cerebral angiogram following the second SAH shows a small aneurysm at the anterior medullary segment of left PICA. B, Selective angiogram of the left vertebral artery at the time of treatment illustrates the PICA aneurysm increased in size in a day and diffuse spasm of the vertebral and basilar artery. C, Postembolization injection of the left vertebral artery demonstrates complete occlusion of the PICA at its origin with coils in the patent artery and the aneurysm.
- Fig 2.
An 80-year-old woman (patient 6) presented with sudden severe headache. A and B, Initial digital subtraction angiogram of the left vertebral artery in the frontal projection and 3D rotational angiogram show a fusiform irregular-shaped aneurysm at the anterior medullary segment with focal irregularity of left PICA, indicating dissection. C, The postembolization angiogram illustrates the dissecting aneurysm and parent artery are occluded.
- Fig 3.
A 35-year-old woman (patient 5) presented with Hunt and Hess grade III SAH. A, A lateral projection of the right vertebral angiogram demonstrates a 3 × 4 mm fusiform aneurysm at the lateral medullary segment of right PICA. B, The aneurysm is treated by endovascular occlusion of dissecting aneurysm and parent artery. The postocclusion angiogram in the lateral projection shows complete obliteration of the PICA trunk and the aneurysm. C, Five-year follow-up DS angiogram; note that the occluded PICA is recanalized without any growth of the aneurysm.
Tables
Characteristics of 6 patients with peripheral dissecting aneurysms of the PICA
Case No. Age/Sex Hunt and Hess Grade Initial CT and MR Imaging Findings Location of Aneurysm Treatment Recurrent Aneurysm Outcome 1 50/F Intracerebellar hematoma Right telovelomedullar Endovascular Yes Excellent 2 62/F Mural hematoma Left lateral medullary Surgery No Excellenta 3 65/M 2 Subarachnoid hemorrhage, intraventricular hemorrhage Left tonsilomedullary Endovascular No Good 4 28/M 5 Subarachnoid hemorrhage, subdural hematoma, contusion Left anterior medullary Endovascular No Good 5 35/F 3 Subarachnoid hemorrhage, intraventricular hemorrhage Right lateral medullary Endovascular No Excellent 6 80/F 1 Subarachnoid hemorrhage, intraventricular hemorrhage Left anterior medullary Endovascular No Excellent -
a Died of renal cell carcinoma 1 year after treatment of dissection.
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