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. 2022 Jun 10;8(1):14.
doi: 10.1186/s41016-022-00281-5.

Spontaneous subarachnoid hemorrhage caused by ruptured aneurysm of basilar trunk perforator: a case report and literature review

Yao Wu  1 , Zhaoliang Li  1 , Dehong Yang  1 , Tao Wu  1 , Ailin Chen  1 , Chungang Dai  1 , Qing Zhu  2
Affiliations

Spontaneous subarachnoid hemorrhage caused by ruptured aneurysm of basilar trunk perforator: a case report and literature review

Yao Wu et al. Chin Neurosurg J. .

Abstract

Background: Aneurysm of basilar perforator was rarely reported in the literature. It is difficult to treat due to its small size and deep-seated location. Excessive treatment may cause complications that resulted from ischemic events of parent perforators. Therefore, it is important to make clinical strategy for such patients to improve the prognosis.

Case presentation: One case, who presented as spontaneous subarachnoid hemorrhage, despite the negative result in computed tomography angiography firstly, was diagnosed angiographically as a ruptured aneurysm of the basilar perforator. A good clinical outcome of the case was achieved during the follow-up after conservative observation for 2 months, as well as the disappearance of previous lesion from angiography.

Conclusions: Aneurysm located at perforator of basilar trunk was rare and difficult to treat. Conservative observation for certain cases with periodic angiography follow-up was considered in order to prevent the patients from potential iatrogenic effects.

Keywords: Basilar trunk; Intracranial aneurysm; Perforator.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Imaging data of the case. A SAH surrounding potine was confirmed by head CT after onset. B Emergency CTA did not demonstrate definite source of hemorrhage. C, D Three-dimensional rotation angiography (3DRA) revealed a small aneurysm localized at posterior perforator of rostral basilar trunk. E, F The lesion disappeared from DSA during 2 months of follow-up with preservation of parent perforator
Fig. 2
Fig. 2
Simulating procedure on printed three dimension model. A Subtemporal keyhole approach of right side. The depth of aneurysm is 7 cm from temporal bone. B The length of visible basilar artery is 5 mm between petrosal apex and neck of aneurysm under the microsurgical corridor. C The aneurysm can be clipped by longer clip after retraction of isplateral superior cerebellar artery. D Relationship of clip and surrounding vascular structures after simulating clip application
See this image and copyright information in PMC

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