AMC succeeds in treating ruptured aneurysm of the cerebellum

Lee Han-soo  Published 2018.08.02  15:29  Updated 2018.08.02 15:29

Professor Seo Dae-chul

An Asan Medical Center team has managed to remove a rare aneurysm in the posterior calcified cerebral artery, which extends from the vertebral artery and supplies blood to the cerebellum, by inserting a small arterial blood flow transducer.

A blood flow transducer is a new neural intervention technique that creates a new pathway in the aneurysm of the cerebral artery and reconstructs the blood vessels while minimizing brain damage by maintaining blood flow. It also helps prevent ruptured aneurysms from relapsing and removes the thrombus.

According to the hospital, the patient who had been controlling his hypertension with exercise and medication visited AMC after having severe headache and vomiting for two months.

The hospital diagnosed the patient with a dissecting spastic cerebral aneurysm with swelling in the posterior calcifying cerebral artery, which was causing the vein walls to deteriorate.

An embolization procedure is one of the most conventional operations that can lower the risk of a ruptured cerebral hemorrhage. However, such methods may cause cerebellar infarction. Therefore, some doctors usually opt for vascular bypass surgery, but this surgery also has the potential to cause cranial nerve palsy or brainstem damage.

AMC’s neuro intervention team, led by Professor Seo Dae-chul, managed to deliver the artery from the vertebral artery through the femoral artery without accessing the skull. It then approached the distal end of the calcaneal artery and inserted an arterial blood flow transducer and performed a vascular reconstruction. Professor Seo carried out an angioplasty at the site where vessel reconstruction was incomplete due to vascular dissection.

About 2 percent of the aneurysms patients that visited AMC over the past three years showed symptoms a dissecting spastic cerebral aneurysm. The most common site of dissection is the vertebral artery, while some rarely occur in the vertebral artery branch.

Notably, only 0.1 percent of the patient showed a dissected aneurysm in the posterior calcified cerebral artery supplying blood to the cerebellum from spinal vessels.

“Although dissecting spastic cerebral aneurysm is rare, if not treated on time the illness can cause serious adverse effects such as cerebral hemorrhage or cerebellar palsy,” Professor Seo said. “The hospital recommends patients, who symptoms such as a severe headache or stiff neck after an intense neck exercise, to seek immediate consultations from medical professionals.”

Dissecting cerebral aneurysm is caused by sudden neck movements such as excessive neck exercise, vomiting, and sneezing, Seo added.

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