1/17. Intrameatal aneurysm successfully treated by meatal loop trapping--case report.A 77-year-old female presented with a rare intrameatal aneurysm manifesting as sudden onset of headache, hearing loss, tinnitus, and vertigo associated with subarachnoid hemorrhage. Meatal loop trapping was performed. After surgery, the patient's functions recovered almost completely, probably because of the preservation of the 7th and 8th cranial nerves and the presence of effective collaterals in the area supplied by the anterior inferior cerebellar artery.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
2/17. Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report.A 71-year-old female had vertigo attacks once or twice a day secondary to vertebrobasilar insufficiency. Left carotid angiography revealed persistent primitive hypoglossal artery (PPHA) associated with a large internal carotid artery (ICA) aneurysm and severe stenosis of the ICA. The bilateral vertebral arteries were hypoplastic. The basilar artery was opacified via the PPHA but not via vertebral arteries. Clipping of the aneurysm was performed first because the risk of rupture of the aneurysm was not negligible. One month after clipping, carotid endarterectomy using a T-shaped shunt system was successfully performed. The postoperative course was uneventful and the vertebrobasilar ischemic attacks did not recur. Left carotid angiography demonstrated complete obliteration of the aneurysm and disappearance of the carotid artery stenosis. Low ICA flow (70 ml/min) and low stump pressure of the PPHA (25 mmHg) strongly suggested low perfusion of the posterior circulation. Carotid endarterectomy may be essential for augmentation of the posterior circulation in patients with PPHA associated with ICA stenosis.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
3/17. Distal anterior inferior cerebellar artery aneurysms. Report of four cases.Aneurysms of the distal anterior inferior cerebellar artery (AICA) are rare; fewer than 100 cases have been reported. The authors detail their experience with four cases and present endovascular as well as microsurgical management options. The medical records and neuroimaging studies obtained in four patients who were treated at a single institution were reviewed. Clinical presentations, neuroimaging and intraoperative findings, and clinical outcomes were analyzed. There were three men and one woman; their mean age was 43 years. Two patients presented with acute subarachnoid hemorrhage (SAH), and two presented with ataxia and vertigo (one with tinnitus, the other with hearing loss). Angiographic studies demonstrated aneurysms of the distal segment of the AICA. In one patient with von Hippel-Lindau syndrome and multiple cerebellar hemangioblastomas, a feeding artery aneurysm was found on a distal branch of the AICA. Three of the patients underwent successful surgical obliteration of their aneurysms, one by clipping, one by trapping, and one by resection along with the tumor. The fourth patient underwent coil embolization of the distal AICA and the aneurysm. All patients made an excellent neurological recovery. patients with aneurysms in this location may present with typical features of an acute SAH or with symptoms referable to the cerebellopontine angle. Evaluation with computerized tomography, magnetic resonance (MR) imaging, MR angiography, and digital subtraction angiography should be performed. For lesions distal to branches coursing to the brainstem, trapping and aneurysm resection are viable options that do not require bypass. Endovascular obliteration is also a reasonable option, although the possibility of retrograde thrombosis of the AICA is a concern.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
4/17. Distal anterior inferior cerebellar artery aneurysm occult on magnetic resonance angiography one month prior to rupture--case report.A 77-year-old man suffered subarachnoid hemorrhage due to a ruptured aneurysm of the distal anterior inferior cerebellar artery (AICA). He had a history of hearing disturbance in the left ear for more than 3 years. Computed tomography on three separate occasions had found no abnormalities. One month before the hemorrhage, he came to our outpatient service complaining of vertigo. Magnetic resonance (MR) imaging and MR angiography detected no abnormality. Conventional angiography demonstrated an aneurysm of 8 mm diameter in the distal AICA region after the hemorrhage. Filling and wash out of the aneurysm sac by contrast medium was markedly delayed, which suggested that MR imaging had failed to detect the flow void because of the slow blood flow in the dome. The aneurysm was clipped successfully. He was discharged with mild dysarthria on the 33rd postoperative day. MR angiography has limitations in detecting unruptured aneurysms and there is certainly a high risk group of false negatives, including aneurysms located in the distal region of the main trunk.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
5/17. Development and rupture of a de novo basilar artery aneurysm after surgical removal of a cerebellar arteriovenous malformation.BACKGROUND: The de novo development of an aneurysm in an previously normal artery is an uncommon event. We describe a patient who developed a de novo bleeding aneurysm of the basilar artery in the three weeks following the surgical removal of a large cerebellar AVM. METHOD-FINDINGS: A 48-year-old man suddenly developed transient headache, vertigo and disturbance of balance. Neuroradiological examinations showed the presence of a large AVM of the right cerebellar hemisphere. The AVM was removed successfully; following the operation there were repeated bleeding episodes at the operating site, requiring surgical evacuation. Three weeks after the AVM removal he suffered from a massive subarachnoid haemorrhage due to the rupture of an aneurysm developed de novo in the basilar artery. INTERPRETATION: This is the first reported case, to our knowledge, of a de novo aneurysm developed in an artery hemodynamically related to a surgically removed AVM. This complication was probably due to the postoperative hemodynamic changes in the vessels afferent to the AVM, associated with arterial wall dysplasia.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
6/17. Acute cerebellar vertigo in a fighter pilot.vertigo is a frequently encountered complaint among aviators. This complaint is usually labyrinthine in origin. We present a case of a combat jet fighter pilot who experienced a vertiginous episode during flight that nearly resulted in a mishap. work-up revealed a dissecting aneurysm of the posterior inferior cerebellar artery. Coiling of the aneurysm was performed. This case emphasizes the importance of performing a complete vestibular evaluation in aviators with acute vertigo. Since central nervous system causes may be responsible for vertiginous events, and when undiagnosed may result in a recurrence during flight, magnetic resonance scanning should be considered in those with no obvious peripheral cause for their vertigo.- - - - - - - - - - ranking = 6keywords = vertigo (Clic here for more details about this article) |
7/17. Persistent primitive trigeminal artery aneurysm associated with cerebellar hemangioblastoma. Case report.A 72-year-old man presented with a cerebellar vermian tumor manifesting as headaches and vertigo. angiography disclosed a vascular tumor fed by the superior cerebellar artery and an aneurysm of a primitive trigeminal artery. The patient underwent right occipital craniotomy to remove the highly vascular tumor via an occipital transtentorial approach. association of a cerebral aneurysm with a hemangioblastoma has been reported previously in only five cases. Only three aneurysms were located on the feeding artery. The aneurysm in this case was not on the feeding artery. Simple coincidence might account for this case.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
8/17. Excision and end-to-end anastomosis of a fusiform aneurysm of the distal posterior inferior cerebellar artery associated with ischemia--case report.A 35-year-old male with a sudden onset of severe vertigo and vomiting had a fusiform aneurysm of the distal portion of the left posterior inferior cerebellar artery. The symptoms were caused by cerebellar infarction probably due to an embolism from the aneurysm. The aneurysm was excised and the artery reconstructed by end-to-end anastomosis with an excellent outcome. Histological examinations showed mural thrombus but no wall dissection.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
9/17. Endovascular coil embolization of unusual posterior inferior cerebellar artery aneurysms.Three patients underwent transarterial platinum coil embolization of unusual posterior inferior cerebellar artery aneurysms. In one case, a giant, bilobed, partially thrombosed aneurysm exhibited marked mass effect on the adjacent medulla. In the second case, diffuse severe cerebral vasospasm, 3 days after subarachnoid hemorrhage, rendered transvascular treatment of the aneurysm difficult. Increasing vertigo and nausea caused by mass effect from an aneurysm previously coated with methyl methacrylate warranted treatment in the third case. Indications for transvascular coil treatment included relative surgical inaccessibility to the aneurysm, and, in our case, inability to perform transarterial detachable balloon therapy. The aneurysms were obliterated by endovascular coil embolization in each case. In the patient with vasospasm, aneurysm treatment followed angioplasty of the major affected cerebral vessels, resulting in significant neurological improvement within 24 hours. Two patients were neurologically intact at the time of discharge, and the third displayed persistent cerebellar signs despite a marked decrease in vertigo and nausea. Reports of transvascular coil embolization of intracranial aneurysms are very rare. Our experience with these patients demonstrates that this technique can be successfully utilized in selected cases.- - - - - - - - - - ranking = 2keywords = vertigo (Clic here for more details about this article) |
10/17. Intracranial dissecting aneurysm. Report of a case.The case of a 47-year-old man who died one month after a history of paroxysmal occipital headaches, vertigo, vomiting, weakness, and sweating is presented. The death was due to a pontine softening caused by a subintimal dissecting aneurysm of the two vertebral, the basilar and the right posterior inferior cerebellar arteries. No etiological factor of the illness could be found. The clinical signs resembled those of a flap-valve tumor of the IIIrd ventricle.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
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