Diagnoses and treatments of superior cerebellar artery aneurysms: an analysis of 16 cases
10.3760/cma.j.issn.1671-8925.2019.04.006
- VernacularTitle:小脑上动脉动脉瘤的诊断和治疗(附16例报道)
- Author:
Xiaoping TANG
1
;
Junwei DUAN
;
Long ZHAO
;
Hua PENG
;
Tao ZHANG
;
Binbin YANG
;
Xiaohong YIN
;
Shun LI
;
Haogeng SUN
;
Yuanchuan WANG
;
Renguo LUO
Author Information
1. 川北医学院附属医院神经外科
- Keywords:
Superior cerebellar artery aneurysm;
Intracranial aneurysm;
Interventional embolization;
Surgical clipping
- From:
Chinese Journal of Neuromedicine
2019;18(4):357-362
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features,diagnoses,differential diagnoses and treatments of superior cerebellar artery aneurysms.Methods The clinical data of 16 patients with superior cerebellar artery aneurysms,admitted to our hospital from January 2013 to March 2018,were retrospectively collected.Their clinical manifestations,imaging features,surgical effects and related problems in the process of diagnoses and treatments were analyzed.Results Among the 16 patients,11 were caused by aneurysm rupture;8 had subarachnoid hemorrhage alone,and three had subarachnoid hemorrhage accompanied by ventricular hemorrhage;CT and CTA confirmed that 8 were superior cerebellar artery aneurysms,two were posterior cerebral artery aneurysms,and one was with unclear diagnosis.In the other 5 patients,three had eyelid ptosis and two had abducent nerve palsy;CT,CTA or MR imaging showed that two were considered as ventral brainstem occupying lesions,and three did not have clear diagnosis.Finally,all patients were diagnosed as having superior cerebellar artery aneurysms by three-dimensional DSA.Five patients were treated with interventional embolization first,and one was treated with surgical clipping because of vertebral artery stenosis and difficulty of catheter access;two patients were transferred to our department for surgical clipping due to aneurysm rupture after embolization treatment in other hospitals;and 9 patients were treated by surgical clipping directly.After treatments,one patient was in bed for a long time due to cerebellar infarction and systemic complications,and the other 15 patients recovered well;two of them underwent ventricular peritoneal shunt due to hydrocephalus.Conclusions Superior cerebellar artery aneurysm has onset of subarachnoid hemorrhage mostly,and oculomotor and abductor nerve paralysis,and space occupying manifestation around the brainstem sometimes.For patients with suspicious posterior circulation aneurysms whose diagnosis or location are unclear,three-dimensional DSA examination should be performed early to confirm the diagnosis.Treatment should be taken as soon as possible once the superior cerebellar artery aneurysm is defined.Interventional embolization may be the first choice,but it is necessary to master the methods of surgical clipping in order to treat the disease timely.
