Bradac G B, Bergui M
Neuroradiology, Università di Torino, 15 via Cherasco, 10126, Turin, Italy.
Neuroradiology. 2004 Dec;46(12):1006-11. doi: 10.1007/s00234-004-1245-8. Epub 2004 Dec 3.
Aneurysms may arise at various locations along the course of the posterior inferior cerebellar artery. Brainstem and cranial nerves manipulation make the surgical approach to proximal aneurysms difficult, while the occlusion of the parent vessel is sometimes unavoidable in peripheral aneurysms. Endovascular treatment can be a good alternative, but also with this approach the location of the aneurysm is critical. If occlusion of the parent vessel is planned, anatomical variations and vascular territories of the brainstem should be considered. We report our experience with 18 consecutive aneurysms (12 proximal, 6 peripheral) treated by coils. Complete occlusion was achieved in 14 patients and subtotal in 4. In three patients the parent vessel had to be sacrificed. During treatment two perforations occurred; aneurysms were completely occluded without clinical consequences. Two small asymptomatic cerebellar infarctions were seen on postoperative computed tomography. Clinical outcome was good in 16 patients.
小脑后下动脉走行的不同部位均可发生动脉瘤。脑干和颅神经的操作使得近端动脉瘤的手术入路困难，而周围动脉瘤有时不可避免地要闭塞载瘤血管。血管内治疗可能是一种很好的选择，但采用这种方法时，动脉瘤的位置也很关键。如果计划闭塞载瘤血管，应考虑脑干的解剖变异和血管分布区。我们报告了连续18例采用弹簧圈治疗的动脉瘤（12例近端动脉瘤，6例周围动脉瘤）的经验。14例患者实现了完全闭塞，4例为次全闭塞。3例患者不得不牺牲载瘤血管。治疗过程中发生了2次穿孔；动脉瘤完全闭塞，未产生临床后果。术后计算机断层扫描发现2例小的无症状小脑梗死。16例患者临床结果良好。
