Case reportEndovascular treatment of kissing aneurysms at the fenestrated basilar artery: Case report with literature review
Section snippets
Case report
A 20-year-old man was admitted to another hospital with sudden loss of consciousness. Noncontrast computed tomography (CT) obtained on the same day revealed diffuse subarachnoid hemorrhage. Magnetic resonance imaging (MRI) showed a lobulated aneurysm at the proximal basilar artery associated with fenestration at the aneurysm site (Figure 1). The patient was transferred to our hospital the following day. He was drowsy and his state of alertness was impaired. He was unable to obey commands and
Discussion
Fenestration of intracranial arteries is a rare anomaly and the true incidence is difficult to ascertain, with the data varying among series. In the large angiographic series of Sanders et al. [14] the incidence of fenestration was reported to be 0.72%, most of which were located at the basilar artery (0.31%), followed by the vertebral artery. They found the incidence of associated aneurysm at the fenestration site to be 3% in general and 7% at the basilar artery. In the series of Tasker and
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Cited by (39)
Treatment of fenestrated vertebrobasilar junction-related aneurysms with endovascular techniques
2016, Journal of Clinical NeuroscienceArterial fenestrations and their association with cerebral aneurysms
2014, Journal of Clinical NeuroscienceHuman basilar artery abnormalities in the prenatal and postnatal period
2013, World NeurosurgeryCitation Excerpt :The simultaneous presence of the basilar fenestration and persistent trigeminal artery (22) or unnamed carotid-basilar anastomosis (50) also was reported. The presence of one fenestration in the proximal (36, 41) or in mid-portion (1) of the BA and two associated aneurysms also were described. The association of double fenestrations and an aneurysm was reported by Chen et al. (9).
Clinical presentation and treatment of aneurysms associated with basilar artery fenestration
2012, Journal of Clinical NeuroscienceCitation Excerpt :Aneurysms (AN) associated with a fenestrated basilar artery (fBA–AN) are uncommon; their incidence is reported to be 0.33% of all intracranial aneurysms.1 Since 1980, only 73 patients have been reported in the literature.1–23 The angiographically confirmed incidence of BA fenestration is 0.31% to 0.6%24,25; and based on magnetic resonance (MR) angiography, its incidence is 2%.26
Kissing aneurysms of the distal anterior cerebral artery
2011, Journal of Clinical NeuroscienceCitation Excerpt :Fortunately, the two aneurysms were clipped separately without premature rupture in our patient. Endovascular approaches have been also applied to treat kissing aneurysms, especially those in the posterior circulation.9,13,18 Imai recommended endovascular treatment because of the potential risk of premature rupture during surgery.5