Ruptured Basilar Artery Perforator Aneurysm: A Case Report and Review of the Literature

DOI Web Site 被引用文献4件 参考文献20件 オープンアクセス
  • Enomoto Noriya
    Department of Neurosurgery, Tokushima Prefectural Central Hospital, Tokushima, Tokushima, Japan
  • Shinno Kiyohito
    Department of Neurosurgery, Tokushima Prefectural Central Hospital, Tokushima, Tokushima, Japan
  • Tamura Tetsuya
    Department of Neurosurgery, Tokushima Prefectural Central Hospital, Tokushima, Tokushima, Japan
  • Shikata Eiji
    Department of Neurosurgery, Tokushima Prefectural Central Hospital, Tokushima, Tokushima, Japan
  • Shono Kenji
    Department of Neurosurgery, Tokushima Prefectural Central Hospital, Tokushima, Tokushima, Japan
  • Takase Kensaku
    Department of Neurosurgery, Tokushima Prefectural Central Hospital, Tokushima, Tokushima, Japan

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説明

<p>Basilar artery perforator aneurysms (BAPAs) are a rare cause of subarachnoid hemorrhage (SAH), and the natural history is still unknown. Herein, we report a case of ruptured BAPA that appeared during the observation period and then spontaneously disappeared; we have also conducted a review of the literature and performed an analysis based on the type of management. This case of BAPA had a unique course, and our observations may help establish a treatment strategy. A 60-year-old man presented with acute diffuse SAH, World Federation of Neurosurgical Societies (WFNS) Grade II and Fisher Grade 3. Initial three-dimensional digital subtraction angiography (DSA) did not show the source of the hemorrhage. DSA performed on day 39 showed a BAPA with a diameter of 3 mm at the posterior surface of the upper third of the basilar artery. Conservative treatment was chosen. DSA performed on day 64 showed complete resolution of the aneurysm. BAPAs are likely pseudoaneurysms, and not saccular aneurysms, caused due to dissection of basilar perforator arteries. BAPAs are often not recognized on initial imaging, and hence, it is necessary to repeat the DSA examination. Considering the relatively high rate of spontaneous resolution, we chose conservative management. When BAPAs enlarge or do not disappear after conservative treatment, additional therapy such as multiple stents should be considered.</p>

収録刊行物

  • NMC Case Report Journal

    NMC Case Report Journal 7 (3), 93-100, 2020

    一般社団法人 日本脳神経外科学会

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