Combined surgical and endovascular treatment of a giant vertebral artery aneurysm in a child. Case report.
The case is presented of a 5-year-old child who suffered a subarachnoid hemorrhage from a giant left vertebral artery-posterior inferior cerebellar artery (PICA) aneurysm. Initial treatment consisted of surgical occlusion of the parent vertebral artery combined with a PICA-to-PICA bypass. Because of persistent filling of the aneurysm, the left PICA was occluded at its takeoff from the aneurysm. Endovascular coil occlusion of the aneurysm and the distal left vertebral artery enabled complete elimination of the aneurysm. Follow-up magnetic resonance imaging and arteriography performed 6 months postoperatively showed persistent occlusion and elimination of the mass effect. Combined surgical bypass and endovascular occlusion of the parent artery may be a useful adjunct in the management of these aneurysms.
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
M H
MH
Khayata
R F
RF
Spetzler
J J
JJ
Mooy
J M
JM
Herman
H L
HL
Rekate
D000714:Anastomosis, Surgical; D000783:Aneurysm / Q000601:surgery* / Q000628:therapy*; D001158:Arteries; D002531:Cerebellum / Q000098:blood supply; D002675:Child, Preschool; D003097:Collateral Circulation; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008026:Ligation; D008297:Male; D008526:Medulla Oblongata / Q000098:blood supply; D014711:Vertebral Artery / Q000473:pathology / Q000601:surgery*