P V Theodosopoulos1, M T Lawton. 1. Department of Neurological Surgery, School of Medicine, University of California San Francisco, USA.
Abstract
OBJECTIVE AND IMPORTANCE: Fenestrations of cerebral arteries are rare, but very important to diagnose given their high association with saccular aneurysms. We present the first reported case of a fenestration of the posteroinferior cerebellar artery (PICA). CLINICAL PRESENTATION: A 62-year-old man who presented with a subarachnoid hemorrhage underwent repeated four-vessel cerebral angiography. An isolated right PICA abnormality consistent with a dissection or fenestration was revealed. INTERVENTION: The patient underwent surgical exploration of his PICA, which confirmed a PICA fenestration without an associated saccular aneurysm. The fenestration was wrapped with cotton. CONCLUSION: Our case report illustrates the novel anatomic finding of a fenestration of the PICA. Knowledge of this entity would be helpful in the differential diagnosis of a posterior fossa subarachnoid hemorrhage.
OBJECTIVE AND IMPORTANCE: Fenestrations of cerebral arteries are rare, but very important to diagnose given their high association with saccular aneurysms. We present the first reported case of a fenestration of the posteroinferior cerebellar artery (PICA). CLINICAL PRESENTATION: A 62-year-old man who presented with a subarachnoid hemorrhage underwent repeated four-vessel cerebral angiography. An isolated right PICA abnormality consistent with a dissection or fenestration was revealed. INTERVENTION: The patient underwent surgical exploration of his PICA, which confirmed a PICA fenestration without an associated saccular aneurysm. The fenestration was wrapped with cotton. CONCLUSION: Our case report illustrates the novel anatomic finding of a fenestration of the PICA. Knowledge of this entity would be helpful in the differential diagnosis of a posterior fossa subarachnoid hemorrhage.
Authors: Daniel L Cooke; Charles E Stout; Warren T Kim; Akash P Kansagra; John Paul Yu; Amy Gu; Nicholas P Jewell; Steven W Hetts; Randall T Higashida; Christopher F Dowd; Van V Halbach Journal: Interv Neuroradiol Date: 2014-06-17 Impact factor: 1.610