Top

Acta Neurochirurgica

Published in:

01-02-2009 | Case Report

Subarachnoid haemorrhage due to a lateral spinal artery aneurysm misdiagnosed as a posterior inferior cerebellar artery aneurysm: case report and literature review

Authors: Mari Kurita, Masataka Endo, Takao Kitahara, Kiyotaka Fujii

Published in: Acta Neurochirurgica | Issue 2/2009

Abstract

Clinical Description

A 61 year old man presenting with subarachnoid haemorrhage had a distal posterior inferior cerebellar artery (PICA) aneurysm diagnosed on the initial cerebral angiogram. However, a PICA aneurysm was not found during surgery. A follow-up, super-selective vertebral artery (VA) performed demonstrated a saccular aneurysm located on the lateral spinal artery (LSA). A right sub-occipital craniotomy was performed and the aneurysm arising was identified and obliterated with a small titanium clip.

Conclusion

We describe the first example of an LSA aneurysm without occlusion or severe stenosis of the VA and PICA. This extremely rare lesion illustrates how knowledge of the angiographic features and super-selective cerebral angiography aids the precise diagnosis and the prevention of surgical complications.

Andoh T, Shirakami S, Nakashima T, Nishimura Y, Sakai N, Yamada H, Ohkuma A, Tanabe Y, Funakoshi T (1992) Clinical analysis of a series of vertebral aneurysm cases. Neurosurgery 31:987–993PubMedCrossRef

Chen CC, Bellon RJ, Ogilvy CS, Putman M (2001) Aneurysms of the lateral spinal artery: report of two cases. Neurosurgery 48:949–954PubMedCrossRef

Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6(1):1–9PubMedCrossRef

Gacs G, Vinuela F, Fox AJ, Drake CG (1983) Peripheral aneurysms of the cerebellar arteries: review of 16 cases. J Neurosurg 58:63–68PubMed

Graeb DA, Roberson WD, Lapoine JS, Nugent RA, Harrison PB (1982) Computed tomographic diagnosis of intraventricular hemorrhage: etiology and prognosis. Radiology 143:91–96PubMed

Ghogawala Z, Shumacher JM, Ogilvy GS (1996) Distal basilar perforator artery aneurysm: case report. Neurosurgery 39:393–396PubMedCrossRef

Hamel W, Gysyska U, Westphal M, Kehler U (2005) Surgical treatment of a basilar perforator aneurysm not accessible to endovascular treatment. Acta Neurchir (Wien) 147(12):1283–1286CrossRef

Hlavin ML, Tanaoka Y, Snith AS (1991) A PICA communicating artery aneurysm: case report. Neurosurgery 29:926–929PubMedCrossRef

Kubota H, Suehiro E, Yoneda H, Nomura S, Kajiwara K, Fujii M, Fujisawa H, Kato S, Suzuki M (2006) Lateral spinal artery aneurysm associated with a posterior inferior cerebellar artery main trunk occlusion: case illustration. J Neurosurg: Spine 4:347CrossRef

10.

Lasjaunias P, Berenstein A: Arterial anatomy (1987) Introduction, in Lasjaunias P, Berenstein A (eds): Surgical Neuroangiography: Functional anatomy of cranio-facial arteries. Heidelberg, Springer-Verlag, vol 1, pp 1–32.

11.

Lasjaunias P, Valee B, Person H, Brugge KT, Chiu M (1985) The lateral spinal artery of the upper cervical spinal cord. J Neurosurg 63:235–241PubMedCrossRef

12.

Lewis SB, Chang DJ, Peace DA, LaFrents PJ, Day AL (2005) Distal posterior inferior cerebellar artery aneurysms: clinical features and management. J Neurosurg 97:756–766

13.

Peluso JPP, van Rooji WJ, Sluzewski M, Beute GN (2007) Distal aneurysms of cerebellar arteries: incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. AJNR 28:1573–1578PubMed

14.

Salcman M, Rigamonti D, Numaguchi Y, Sadato N (1990) Aneurysms of the posterior inferior cerebellar artery–vertebral artery complex: variation on a theme. Neurosurgery 27:12–21PubMedCrossRef

Title: Subarachnoid haemorrhage due to a lateral spinal artery aneurysm misdiagnosed as a posterior inferior cerebellar artery aneurysm: case report and literature review
Authors: Mari Kurita
Masataka Endo
Takao Kitahara
Kiyotaka Fujii
Publication date: 01-02-2009
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 2/2009
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-009-0183-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Subarachnoid haemorrhage due to a lateral spinal artery aneurysm misdiagnosed as a posterior inferior cerebellar artery aneurysm: case report and literature review

Abstract

Clinical Description

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Clinical Description

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2009

Cavernous angiomas of the lateral ventricles

Radiosurgery for large cerebral arteriovenous malformations

Editorial: on the road to multi-modal and pluri-disciplinary treatment of glioblastomas

Dural bridge sutures to prevent sinking of dural substitutes: technical note

Fronto-mesial WHO grade II and III gliomas: specific aspects of tumours arising from the anterior cingulate gyrus

CME for neurosurgeons in the Netherlands: the “quality” conferences