Hemorrhagic Distal Posterior Inferior Cerebellar Arterial Dissection Arising from the Stenotic Lesion without Any Significant Long-term Interval Changes / 後下小脳動脈の狭窄病変から長期経過後に出血発症した脳動脈解離の1例
- Resource Type
- Journal Article
- Authors
- Hideyuki TOMITA; Katsuya SAITO; Kazunori AKAJI; 冨田 栄幸; 斉藤 克也; 赤路 和則
- Source
- 脳卒中の外科 / Surgery for Cerebral Stroke. 2015, 43(1):49
- Subject
- aneurysmal dilatation
distal PICA
endovascular surgery
non-hemorrhagic dissecting aneurysm
subarachnoid hemorrhage
- Language
- Japanese
- ISSN
- 0914-5508
1880-4683
We present a case of distal posterior inferior cerebellar artery (PICA) dissection with subarachnoid hemorrhage that was difficult to diagnose. A 72-year-old woman with a 2-year history of saccular cerebral aneurysm clipping presented with recurrent subarachnoid hemorrhage. Angiograms after the first and second subarachnoid hemorrhage showed irregular stenosis of the distal PICA that was thought to be arteriosclerotic change because of the same finding on previous angiograms. After the third subarachnoid hemorrhage, angiogram revealed aneurysmal dilatation from the irregular stenosis of the distal PICA. Based on the clinical course and interval change in angiographic findings after each episode, this patient was diagnosed with a distal PICA dissecting aneurysm with a hemorrhagic onset and was successfully treated with endovascular surgery. We present this case with a review of the literature.