Surgical Management and Outcomes of Aneurysms of Posterior Inferior Cerebellar Artery: Location-Based Approaches with Review of Literature

Autor:	Dwarakanath Srinivas, Bhaskara Rao Malla, Sampath Somanna, Priyadarshi Dixit, K.V.L. Narasinga Rao, Nitish Nayak, V. Vikas, Harsh Deora, Dhananjay I Bhat, Nupur Pruthi, B.I. Devi, Dhaval Shukla
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	medicine.medical_specialty Subarachnoid hemorrhage subarachnoid hemorrhage Vertebral artery 030218 nuclear medicine & medical imaging lcsh:RC321-571 03 medical and health sciences 0302 clinical medicine Aneurysm suboccipital approach medicine.artery Cerebrospinal fluid diversion medicine Pica (disorder) cardiovascular diseases posterior inferior cerebellar artery aneurysm lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry business.industry General Neuroscience medicine.disease Dissection Posterior inferior cerebellar artery medicine.anatomical_structure Original Article far-lateral approach Neurology (clinical) Radiology medicine.symptom business Cerebellar artery 030217 neurology & neurosurgery
Zdroj:	Journal of Neurosciences in Rural Practice Journal of Neurosciences in Rural Practice, Vol 11, Iss 01, Pp 034-043 (2020)
ISSN:	0976-3155 0976-3147
Popis:	Background Posterior inferior cerebellar artery (PICA) is a tortuous, variable, and uncommon site for aneurysms. Surgical management of PICA aneurysms involves careful selection of approach based on the location of the aneurysm and meticulous dissection of the neurovascular structures and perforators. Materials and Methods We did a retrospective review of all the PICA aneurysms operated at our institute in the past 10 years along with the site, presentation, and approach used for the same. Preoperative World Federation of Neurosurgical Society scores and follow-up modified Rankin scores (mRS) were also evaluated. During the same period, data for intervention cases of PICA aneurysm were also collected with follow-ups for a comparative analysis. Results A total of 20 patients with 21 PICA aneurysms were reviewed. All the reviewed cases presented with subarachnoid hemorrhage, and the most common location was the lateral medullary segment and vertebral artery (VA)–PICA junction. Midline approaches were used for distal PICA cases, with far-lateral approach reserved for anterior medullary/VA–PICA junction. No lower cranial nerve palsies were recorded at follow-up. Four cases needed cerebrospinal fluid diversion and two developed cerebellar infarcts. All cases were mRS 0 to 2 at follow-up. Conclusion Our series compares well with some of the larger surgical series of PICA aneurysms. This may be due to early referral patterns and early surgery (
Databáze:	OpenAIRE
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