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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(10): 758-759
DOI: 10.1590/0004-282X20170143
IMAGES IN NEUROLOGY

Dissecting superior cerebellar artery aneurysm: spontaneous resolution in a long-term follow-up

Aneurisma dissecante de artéria cerebelar superior: resolução espontânea após seguimento de controle
Marcos Vinicius Tadao Fujino
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
,
Rogério Iquizli
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
,
Thiago Abud
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
,
Carlos Eduardo Baccin
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
,
Gisele Sampaio Silva
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
2   Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brasil.
,
Orlando G. Barsottini
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
2   Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brasil.
,
José Luiz Pedroso
1   Hospital Israelita Albert Einstein, São Paulo SP, Brasil;
2   Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brasil.
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A 48-year-old woman presented with sudden posterior neck pain 12 hours before admission. Past medical history was unremarkable. Neurological examination was normal. A brain CT scan and cerebrospinal fluid were normal. A MRI angiography (MRA) and digital angiography confirmed a dissecting superior cerebellar artery (SCA) aneurysm ([Figure 1]). We decided for noninvasive therapy. Six months later, the MRA showed complete resolution ([Figure 2]).

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Figure 1 Axial post-contrast brain MRI (vessel wall imaging) shows abnormal asymmetric vessel wall enhancement in left superior cerebellar artery (A); axial 3D-TOF MRI angiography shows segmental ectasia in the left superior cerebellar artery (B). Digital subtraction angiogram of the left vertebral artery and 3D reconstructions confirmeda dissecting superior cerebellar artery aneurysm (lateral pontomesencephalic segment) (arrows) (C and D).
Zoom Image
Figure 2 Six-month follow-up. Axial post-contrast brain MRI (vessel wall imaging) shows no enhancement in left superior cerebellar artery (A); axial 3D-TOF MRI angiography shows no artery aneurysm (B).

Fusiform aneurysms of the SCA related to dissection are rare[1],[2]. Treatment strategies are usually aggressive and include: aneurysm clipping, arterial bypasses and artery oclusion[1],[2],[3]. Our report suggests that noninvasive therapy should be considered as an option for unruptured fusiform aneurysms of the SCA related to dissection.



Publication History

Received: 15 January 2017

Accepted: 18 July 2017

Article published online:
04 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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