Subarachnoid Hemorrhage from a Dissecting Aneurysm of the Posterior Cerebral Artery in a Child : Rebleeding after Stent-Assisted Coiling Followed by Stent-Within-Stent Technique. |
Ji Yeoun Lee, Bae Ju Kwon, Hyun Seung Kang, Kyu Chang Wang |
1Division of Pediatric Neurosurgery, Department of Neurosurgery, Seoul National University Children's Hospital, Seoul, Korea. kcwang@snu.ac.kr 2Department of Radiology, Seoul National University College of Medicine, Seoul, Korea. |
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ABSTRACT |
Pediatric patients with dissecting aneurysms usually present with ischemia rather than bleeding. We report a case of a 15-year-old boy with a dissecting aneurysm of the posterior cerebral artery (PCA) presenting with hemorrhage. He was first treated with stent-assisted coil embolization, in an attempt to avoid trapping of the PCA and preserve the perforators. After the procedure, he recovered well from general anesthesia, but rebleeding occurred from the same lesion 6 hours after the procedure, therefore endovascular segmental occlusion of the parent artery was performed secondarily. Apparently, a reconstructive method of stent-assisted coiling is worth trying to preserve the parent vessel and perforators, but it is not always efficient and durable for dissecting aneurysms. |
Key Words:
Subarachnoid hemorrhage; Dissecting aneurysm; Posterior cerebral artery; Children; Stent-assisted coil embolization |
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