Development of unusual collateral channel from the posterior meningeal artery after endovascular proximal occlusion of the posterior inferior cerebellar artery.
A 38-year-old man presented with a dissecting aneurysm of the left proximal posterior inferior cerebellar artery (PICA) manifesting as Wallenberg's syndrome. The patient was treated by endovascular occlusion of the aneurysm and parent artery. Immediately after the treatment, the PICA territory was supplied by collateral circulation via the ipsilateral anterior inferior cerebellar artery. Seven days later, endogenous revascularization of the distal PICA territory had occurred via collateral circulation from the posterior meningeal artery (PMA). This unusual collateral circulation was thought to occur through a pre-existing anastomotic channel between the primitive vessels of the PICA and the PMA during subclinical hypoperfusion of the distal PICA territory. This unusual case demonstrates the potential for delayed development of collateral circulation from the PMA to the PICA territory.
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
Masanori
M
Tsutsumi
Kiyoshi
K
Kazekawa
Hiroshi
H
Aikawa
Minoru
M
Iko
Tomonobu
T
Kodama
Kouhei
K
Nii
Shuko
S
Matsubara
Housei
H
Etou
Kimiya
K
Sakamoto
Akira
A
Tanaka
D000328:Adult; D002531:Cerebellum / Q000098:blood supply*; D003097:Collateral Circulation / Q000502:physiology*; D004621:Embolization, Therapeutic; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D014854:Lateral Medullary Syndrome / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008576:Meningeal Arteries / Q000503:physiopathology*