Endovascular Management of a Ruptured Basilar Perforator Artery Aneurysm Associated with a Pontine Arteriovenous Malformation: Case Report and Review of the Literature

World Neurosurgery
Joseph LockwoodPeter S Amenta

Abstract

Arteriovenous malformation (AVM)-associated aneurysms are common, reported in 15% of cases. Regarding the ruptured posterior fossa AVMs, associated aneurysms are present in 48% of cases and are the cause of the bleed in 37%. We present a 75-year-old female who presented with a subarachnoid hemorrhage secondary to a ruptured aneurysm arising from a flow-related basilar perforator artery feeder of an anterior pontine AVM. We report the successful treatment of the aneurysm with coil embolization. A 75-year-old female presented with subarachnoid hemorrhage primarily contained within the posterior fossa. Angiography demonstrated a 2 × 3-mm fusiform aneurysm arising from a basilar perforator feeding pedicle of an anterior 1 × 2-cm pontine AVM. Venous drainage from the AVM was predominantly to the superior petrosal vein. Under roadmap guidance, super-selective catheterization of the basilar perforator aneurysm was performed. Three HydroSoft 3D coils were deployed within the aneurysm, resulting in complete obliteration. The patient was discharged on postbleed day 15 to an inpatient rehabilitation facility. Follow-up angiography at 5 months demonstrated stable complete obliteration. The patient made a complete recovery and was living in...Continue Reading

References

Jun 11, 2014·World Neurosurgery·Giuseppe D'AlibertiMichele Nichelatti
Sep 2, 2014·Neurosurgical Focus·Bruno C FloresDuke S Samson
Dec 3, 2014·Clinical Neurology and Neurosurgery·Elsa MagroMichel W Bojanowski
Jul 20, 2016·Handbook of Clinical Neurology·Orlando Diaz, Robert Scranton
Dec 3, 2016·Stroke; a Journal of Cerebral Circulation·Hideyuki KanoL Dade Lunsford
Oct 13, 2017·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Yves ChauJacques Sédat

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Citations

Oct 11, 2019·Journal of Neurointerventional Surgery·Manuel F GranjaRicardo Hanel

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