Development of unusual collateral channel from the posterior meningeal artery after endovascular proximal occlusion of the posterior inferior cerebellar artery |
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Authors: | Tsutsumi Masanori Kazekawa Kiyoshi Aikawa Hiroshi Iko Minoru Kodama Tomonobu Nii Kouhei Matsubara Shuko Etou Housei Sakamoto Kimiya Tanaka Akira |
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Institution: | Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan. |
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Abstract: | 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. |
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