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AJNR - American Journal of Neuroradiology

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Distal Aneurysms of Cerebellar Arteries: Incidence, Clinical Presentation, and Outcome of Endovascular Parent Vessel Occlusion

J.P.P. Peluso^a, W.J. van Rooij^a, M. Sluzewski^a and G.N. Beute^b

^a Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands
^b Department of Neurosurgery, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands

View larger version (19K): [in this window] [in a new window]   Fig 1. A 59-year-old woman with isolated right trochlear nerve palsy. A, MR image demonstrates a partially thrombosed aneurysm lateral to the brain stem. B, A 3D angiogram shows a distal SCA aneurysm (arrow). C, Detail of the 3D angiogram reveals an aneurysm without a neck (double arrow) on the rostral trunk of SCA (arrow).

View larger version (50K): [in this window] [in a new window]   Fig 2. A 68-year-old woman with hemorrhage from a distal SCA aneurysm. A, CT scan shows subarachnoid and intraventricular blood and vermian hematoma. B, A 3D angiogram demonstrates a fusiform aneurysm of the caudal trunk of the SCA (small arrow). Also a small AVM is apparent (large arrow). C and D, Angiograms before (C) and after (D) occlusion of the aneurysm and parent vessel with coils.

View larger version (18K): [in this window] [in a new window]   Fig 3. A 69-year-old woman with hemorrhage from a distal AICA aneurysm. A, A right vertebral angiogram shows a small distal AICA aneurysm (arrow). B, Detail of 3D right vertebral angiogram shows a distal AICA aneurysm without a neck. C, A microcatheter in the AICA just proximal to the aneurysm. The AICA was occluded with coils at this level.

View larger version (32K): [in this window] [in a new window]   Fig 4. A 57-year-old woman with hemorrhage from a distal PICA aneurysm. A, A 3D angiogram demonstrates an aneurysm on the medial cortical branch of the right PICA (arrow), supplying a small torcular AVM, not well demonstrated in this threshold setting (circle). The aneurysm was occluded with coils, including the parent vessel. B, CT scan after 2 weeks reveals infarction in the medial territory of the right PICA.