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. 2007 Sep;49(9):747-51.
doi: 10.1007/s00234-007-0251-z. Epub 2007 Jul 4.

Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment

Jo P P Peluso  1 , Willem Jan van Rooij, Menno Sluzewski, Guus N Beute
Affiliations

Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment

Jo P P Peluso et al. Neuroradiology. 2007 Sep.

Abstract

Introduction: The aim of this retrospective study was to determine the incidence, clinical presentation and midterm clinical and imaging outcome of endovascular treatment of 34 superior cerebellar artery (SCA) aneurysms in 33 patients.

Methods: Between January 1995 and January 2007, 2,112 aneurysms were treated in our institution, and 36 aneurysms in 35 patients were located on the SCA (incidence 1.7%). Two of three distal SCA aneurysms were excluded. All the remaining 34 SCA aneurysms, of which 22 (65%) were ruptured and 12 (35%) were unruptured, in 33 patients were treated by endovascular techniques. There were 6 men and 27 women ranging from 29-72 years. In 14 patients (42%) multiple aneurysms were present.

Results: Initial angiographic occlusion was (near) complete in 32 aneurysms (94%) and incomplete in 2 aneurysms (6%). Complications leading to permanent morbidity or death occurred in two patients (6.1%, 95% CI 0.6 to 20.60%). Outcome at 6 months follow-up in 31 surviving patients was GOS5 in 26 (84%), GOS4 in 4 (13%) and GOS3 in 1 patient (3%). There were no episodes of (re)bleeding during 118 patient-years of follow-up. The 6-month angiographic follow up in 28 SCA aneurysms and extended angiographic follow-up in 19 showed stable occlusion in 27 aneurysms. No additional treatments were performed.

Conclusion: SCA aneurysms are rare with an incidence of 1.7% of treated aneurysms at our institution. They are frequently associated with other aneurysms. Endovascular treatment is effective and safe in excluding the aneurysms from the circulation.

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Figures

Fig. 1
Fig. 1
Incidentally found SCA aneurysm in a 39-year-old man with vertebrobasilar embolic infarcts. a T1-weighted MR image shows a hyperintense lesion adjacent to the brainstem. b 3-D vertebral angiogram reveals a small SCA aneurysm
Fig. 2
Fig. 2
Pre- and posttreatment images of two patients with multiple posterior circulation aneurysms. a A 44-year-old man with a ruptured middle cerebral artery aneurysm and four additional aneurysms. 3-D vertebral angiogram reveals right SCA aneurysm (short single arrow), left distal SCA aneurysm (long single arrow) and basilar tip aneurysm (pair of arrows). b Complete occlusion after coiling. c A 61-year-old woman with a ruptured middle cerebral artery aneurysm and additional aneurysms on the left SCA and basilar tip. d Adequate occlusion of basilar tip and SCA aneurysms
Fig. 3
Fig. 3
Ischemic complication of coiling in a 71-year-old woman with a ruptured SCA aneurysm. a Vertebral angiogram demonstrates a wide-necked right SCA aneurysm with the SCA arising from the sac. b, c Balloon-assisted coiling with adequate occlusion and preserved flow in the SCA. The patient did not awake from general anaesthesia. Immediate control angiography revealed that the SCA had become occluded (not shown). d MRI several days later showing brainstem and cerebellum infarctions in the SCA territory
See this image and copyright information in PMC

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