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Traumatic dissecting pathology of posterior cerebral artery: a report of two cases—aneurysm and pial arteriovenous fistula
  1. Vignesh Selvamurugan1,
  2. Surya Nandan Prasad1,
  3. Vivek Singh1 and
  4. Zafar Neyaz2
  1. 1Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  2. 2Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Vivek Singh; singhvivek79{at}rediffmail.com

Abstract

We present two cases of 17-year-old man and 10-year-old boy presenting with subarachnoid haemorrhage and a history of road traffic accident. One patient had dissecting aneurysm of the posterior cerebral artery (PCA), and the other patient had partially thrombosed aneurysm on CT angiography. On digital subtraction angiography of the second patient, there was formation of PCA pontomesencephalic vein pial arteriovenous fistula (PAVF). Both the patients underwent endovascular treatment: stent-assisted coiling for aneurysm and coiling with parent vessel occlusion for PAVF. There were no procedural complications. Follow-up angiography showed no residual aneurysm or fistula. Trauma is one of the recognised causes of dissection, and intracranial dissections can present as stenotic lesions, aneurysms or fistulas, depending on the pathology. Traumatic dissecting PCA aneurysm has been reported in only two case reports previously, and post-traumatic PAVF in PCA has not been reported.

  • neuroimaging
  • neurological injury
  • trauma CNS /PNS
  • interventional radiology
  • neurosurgery

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Footnotes

  • Contributors V Singh and ZN conceived the manuscript. V Selvamurugan prepared the manuscript. SNP collected the images and also helped in manuscript preparation. SNP and V Singh edited the manuscript. The final manuscript was read and approved by all the authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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