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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia AKSONA
Windiani, Pratiwi Raissa
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Challenging Endovascular Treatment of Ruptured Proximal Posterior Inferior Cerebellar Artery Aneurysm: A Case Report Prasetyo, Bambang Tri; Kurniawan, Ricky Gusanto; Rilianto, Beny; Windiani, Pratiwi Raissa; Kelvin, Kelvin Theandro
AKSONA Vol. 4 No. 1 (2024): JANUARY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i1.44640

Abstract

Highlight: Posterior inferior cerebellar artery (PICA) aneurysms are rare in occurence. The endovascular management of PICA aneursysms is challenging due to anatomical difficulties in accessing the site. The rebleeding of PICA aneurysms, although rare than other intracranial anurysms, may still happen and must be considered in their management   ABSTRACT Introduction Aneurysms of the posterior inferior cerebellar artery (PICA) are rare clinical entities with a lower risk of rupture than other intracranial locations. This makes managing PICA aneurysms challenging and important for neurointerventionists to understand. In this case report, we looked at a rare case of PICA aneurysm with post-coiling rebleeding.  Case: We reported a 51-year-old female with complaints of dizziness and vomiting. The patient was found to be hypertensive and a neurologic assessment revealed neck stiffness and left hemiparesis. A computed tomography (CT) scan of the head indicated subarachnoid hemorrhage. CT angiography (CTA) showed an aneurysm at the right proximal PICA. Although endovascular coiling was performed, the patient rebleed one month later. Following the insertion of the second coil, successful embolization was achieved, and the patient showed clinical improvement. Conclusion: PICA aneurysms require careful endovascular management, considering the difficulty of access due to their anatomical location. An understanding of its proper management is of paramount importance to reducing mortality.  
Carotid-Cavernous Fistula: Manifestasi Klinis dan Tatalaksana Putri, Nadira Deanda; Prasetyo, Bambang Tri; Kurniawan, Ricky Gusanto; Rilianto, Beny; Windiani, Pratiwi Raissa; Arham, Abrar
Majalah Kedokteran Indonesia Vol 73 No 2 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.2-2023-880

Abstract

Carotid-cavernous fistula (CCF) is a vascular abnormality that occurs between the internal or external carotid artery and veins within the cavernous sinus. CCFs can be classified as direct (Barrow type A) or indirect CCFs (Barrow types B, C, and D). The causes of direct CCFs are trauma and vascular rupture, whereas indirect CCFs are commonly found in patients with hypertension, connective tissue disorders, pregnancy, and dissection of the internal carotid artery. Signs and symptoms of CCF vary widely, ranging from acute-onset headache, proptosis, diplopia, ophthalmoplegia, conjunctival chemosis, orbital bruit, and blindness, but it can solely manifest as conjunctival redness. Patients with suspected CCF should undergo neuroradiology imaging, followed by endovascular intervention to close the fistula and keep the carotid artery open. With appropriate treatment, complete resolution is expected to occur in all patients.
Co-Authors Arham, Abrar Kelvin, Kelvin Theandro Kurniawan, Ricky Gusanto Prasetyo, Bambang Tri Putri, Nadira Deanda Rilianto, Beny