Clinical, imaging, and treatment characteristics of 11 patients with 13 distal cerebellar artery aneurysms
Patient No./Sex/Age | Presentation | Aneurysm Location | Additional Vascular Disease | Timing (days) | Treatment | Outcome | Duration of Follow-Up (months) |
---|---|---|---|---|---|---|---|
1/F/59 | Trochlear nerve palsy | SCA rostral trunk | None | Coil occlusion aneurysm + SCA rostral branch | No infarction on MRI, trochlear nerve palsy, improved | 12 | |
2/F/68 | SAH + IVH, vermian hematoma, HH IV | SCA caudal trunk | AVM cerebellum | 1 | EVD, coil occlusion aneurysm + SCA caudal branch, γ-knife for AVM scheduled | Partial SCA infarction on MRI, independent | 2 |
3/M/70 | SAH +IVH, HH II | SCA rostral trunk | AVM cerebellum | 1 | Coil occlusion aneurysm + SCA rostral branch, later γ-knife AVM | No infarction on MRI, independent | 39 |
4/M/45 | SAH + IVH, HH II, facial palsy and hearing loss | AICA rostral branch | MCA aneurysm coiled | 4 | Coil occlusion aneurysm + AICA rostral branch | No infarction on MRI, persistent facial palsy and hearing loss, independent | 30 |
5/F/44 | SAH + IVH, HH III, facial palsy and hearing loss | AICA main stem | None | 4 | EVD, coil occlusion aneurysm + AICA main stem | Infarction brachium pontis, persistent facial palsy and hearing loss, independent | 8 |
6/M/63 | SAH + IVH, HH III, facial palsy and hearing loss | AICA main stem | AVM cerebellum | 3 | EVD, coil occlusion aneurysm + AICA main stem, later γ-knife AVM | Infarction brachium pontis, persistent facial palsy and hearing loss, independent | 6 |
7/F/69 | SAH + IVH, HH IV | AICA main stem | None | 1 | EVD, coil occlusion aneurysm + AICA main stem | No infarction on MRI, independent at discharge, sudden death after 2 months, no cause at autopsy, no infarction AICA territory | 2 |
8/M/64 | SAH + IVH, HH IV | AICA main stem, PICA cortical segment | AVM cerebellum | 3 | EVD, coil occlusion aneurysms + AICA main stem/PICA main stem, later γ-knife AVM | No infarction on MRI, independent | 40 |
9/F/57 | SAH + IVH, vermian hematoma, HH IV | PICA medial cortical segment | AVM cerebellum | 14 | EVD, coil occlusion aneurysm + PICA medial branch, later γ-knife AVM | Medial PICA infarction on CT, no gait imbalance, independent | 15 |
10/M/70 | 2 × SAH + IVH, HH V | 2 × PICA cortical segment | AVM cerebellum | 6 | EVD, glue occlusion PICA cortical segment, later surgery for AVM | No infarction on MRI, independent | 24 |
11/M/66 | 2 × SAH + IVH, HH V, exploratory surgery negative for aneurysm | PICA cortical segment | None | 12 | EVD, coil occlusion aneurysm + PICA segment | Partial PICA infarction on CT, dependent in nursing home, died 4 months later of pneumonia | 4 |
Note:—EVD indicates external ventricular drainage; SAH, subarachnoid hemorrhage; IVH, intraventricular hemorrhage; HH, Hunt and Hess scale; MCA, middle cerebral artery; MRI, MR imaging; SCA, superior cerebellar artery; AVM, arteriovenous malformation.