Abstract
Neurovascular diseases of the posterior circulation represent a major cause of morbidity and mortality, which is due in large part to the eloquence of the brainstem and cerebellum and the anatomical constraints of the posterior fossa. A sound understanding of posterior circulation vascular anatomy builds the foundation for the accurate diagnosis and appropriate management of posterior fossa neurovascular ischemic and hemorrhagic disease. This chapter begins with a brief overview of vertebral and basilar arterial anatomy, followed by a comprehensive discussion of brainstem and cerebellar vascular topography in the setting of ischemic stroke. The epidemiology, clinical presentation, prognostic factors, and natural history of brainstem and cerebellar ischemic stroke are highlighted. The second half of the chapter focuses on hemorrhagic diseases of the posterior fossa, reviewing recent data on saccular and fusiform posterior circulation aneurysms, with a focus on specific anatomical factors that influence both microsurgical and endovascular treatment. Subsequently, posterior fossa high-flow vascular malformations are reviewed with an emphasis on contemporary multimodal therapy and the unique clinico-anatomical challenges involved in treating these complex diseases. The chapter concludes with a practical discussion of the vascular imaging evaluation of posterior fossa ischemic and hemorrhagic stroke to aid the treating physician in the rapid and accurate diagnosis of common posterior fossa neurovascular disease.
References
Agid R, Andersson T, Almqvist H, Willinsky RA, Lee SK, terBrugge KG, Farb RI, Soderman M (2010) Negative CT angiography findings in patients with spontaneous subarachnoid hemorrhage: when is digital subtraction angiography still needed? AJNR Am J Neuroradiol 31(4):696–705. doi:ajnr.A1884 [pii]10.3174/ajnr.A1884
Al-Khayat H, White J, Manner D, Samson D (2005a) Upper basilar artery aneurysms: oculomotor outcomes in 163 cases. J Neurosurg 102(3):482–488. https://doi.org/10.3171/jns.2005.102.3.0482
Al-Khayat H, Beshay J, Manner D, White J (2005b) Vertebral artery-posteroinferior cerebellar artery aneurysms: clinical and lower cranial nerve outcomes in 52 patients. Neurosurgery 56(1):2–10. discussion 11
Archer CR, Horenstein S (1977) Basilar artery occlusion: clinical and radiological correlation. Stroke 8(3):383–390
Arnaout OM, Gross BA, Eddleman CS, Bendok BR, Getch CC, Batjer HH (2009) Posterior fossa arteriovenous malformations. Neurosurg Focus 26(5):E12. https://doi.org/10.3171/2009.2.FOCUS0914
Awad IA, Little JR, Akarawi WP, Ahl J (1990) Intracranial dural arteriovenous malformations: factors predisposing to an aggressive neurological course. J Neurosurg 72(6):839–850. https://doi.org/10.3171/jns.1990.72.6.0839
Baird TA, Muir KW, Bone I (2004) Basilar artery occlusion. Neurocrit Care 1(3):319–329. doi:NCC:1:3:319 [pii]10.1385/NCC:1:3:319
Barth A, Bogousslavsky J, Regli F (1993) The clinical and topographic spectrum of cerebellar infarcts: a clinical-magnetic resonance imaging correlation study. Ann Neurol 33(5):451–456. https://doi.org/10.1002/ana.410330507
Bash S, Villablanca JP, Jahan R, Duckwiler G, Tillis M, Kidwell C, Saver J, Sayre J (2005) Intracranial vascular stenosis and occlusive disease: evaluation with CT angiography, MR angiography, and digital subtraction angiography. AJNR Am J Neuroradiol 26(5):1012–1021. doi:26/5/1012 [pii]
Baskaya MK, Coscarella E, Gomez F, Morcos JJ (2005) Surgical and angiographic anatomy of the posterior communicating and anterior choroidal arteries. Neuroanatomy 3:38–42
Batjer H, Samson D (1986) Arteriovenous malformations of the posterior fossa: clinical presentation, diagnostic evaluation and surgical treatment. Neurosurg Rev 9(4):287–296
Biondi A (2006) Trunkal intracranial aneurysms: dissecting and fusiform aneurysms. Neuroimaging Clin N Am 16(3):453–465, viii. doi:S1052-5149(06)00067-0 [pii]10.1016/j.nic.2006.05.006
Bogousslavsky J, Regli F, Maeder P, Meuli R, Nader J (1993) The etiology of posterior circulation infarcts: a prospective study using magnetic resonance imaging and magnetic resonance angiography. Neurology 43(8):1528–1533
Bogousslavsky J, Van Melle G, Regli F (1988) The Lausanne stroke registry: analysis of 1,000 consecutive patients with first stroke. Stroke 19(9):1083–1092
Borden JA, Wu JK, Shucart WA (1995) A proposed classification for spinal and cranial dural arteriovenous fistulous malformations and implications for treatment. J Neurosurg 82(2):166–179. https://doi.org/10.3171/jns.1995.82.2.0166
Bradac GB, Bergui M (2004) Endovascular treatment of the posterior inferior cerebellar artery aneurysms. Neuroradiology 46(12):1006–1011. https://doi.org/10.1007/s00234-004-1245-8
Brandt T, von Kummer R, Muller-Kuppers M, Hacke W (1996) Thrombolytic therapy of acute basilar artery occlusion. Variables affecting recanalization and outcome. Stroke 27(5):875–881
Burger KM, Tuhrim S, Naidich TP (2005) Brainstem vascular stroke anatomy. Neuroimaging Clin N Am 15(2):297–324, x. doi:S1052-5149(05)00039-0 [pii] 10.1016/j.nic.2005.05.005
Caplan LR (1979) Occlusion of the vertebral or basilar artery. Follow up analysis of some patients with benign outcome. Stroke 10(3):277–282
Caplan LR (2005) Dilatative arteriopathy (dolichoectasia): what IS KNOWN AND NOT KNOWN. Ann Neurol 57(4):469–471. https://doi.org/10.1002/ana.20447
Caplan LR, Wityk RJ, Glass TA, Tapia J, Pazdera L, Chang HM, Teal P, Dashe JF, Chaves CJ, Breen JC, Vemmos K, Amarenco P, Tettenborn B, Leary M, Estol C, Dewitt LD, Pessin MS (2004) New England Medical Center posterior circulation registry. Ann Neurol 56(3):389–398. https://doi.org/10.1002/ana.20204
Choi JH, Mohr JP (2005) Brain arteriovenous malformations in adults. Lancet Neurol 4(5):299–308. doi:S1474-4422(05)70073-9 [pii] 10.1016/S1474-4422(05)70073-9
Ciceri EF, Klucznik RP, Grossman RG, Rose JE, Mawad ME (2001) Aneurysms of the posterior cerebral artery: classification and endovascular treatment. AJNR Am J Neuroradiol 22(1):27–34
Cloud GC, Markus HS (2003) Diagnosis and management of vertebral artery stenosis. QJM 96(1):27–54
Cognard C, Gobin YP, Pierot L, Bailly AL, Houdart E, Casasco A, Chiras J, Merland JJ (1995) Cerebral dural arteriovenous fistulas: clinical and angiographic correlation with a revised classification of venous drainage. Radiology 194(3):671–680
Cognard C, Januel AC, Silva NA Jr, Tall P (2008) Endovascular treatment of intracranial dural arteriovenous fistulas with cortical venous drainage: new management using Onyx. AJNR Am J Neuroradiol 29(2):235–241. doi:ajnr.A0817 [pii]10.3174/ajnr.A0817
Collice M, D’Aliberti G, Arena O, Solaini C, Fontana RA, Talamonti G (2000) Surgical treatment of intracranial dural arteriovenous fistulae: role of venous drainage. Neurosurgery 47(1):56–66. discussion 66-57
da Costa L, Thines L, Dehdashti AR, Wallace MC, Willinsky RA, Tymianski M, Schwartz ML, ter Brugge KG (2009a) Management and clinical outcome of posterior fossa arteriovenous malformations: report on a single-Centre 15-year experience. J Neurol Neurosurg Psychiatry 80(4):376–379. doi:jnnp. 2008.152710 [pii]10.1136/jnnp.2008.152710
da Costa L, Wallace MC, Ter Brugge KG, O’Kelly C, Willinsky RA, Tymianski M (2009b) The natural history and predictive features of hemorrhage from brain arteriovenous malformations. Stroke 40(1):100–105. doi:STROKEAHA.108.524678 [pii]10.1161/STROKEAHA.108.524678
Davies MA, TerBrugge K, Willinsky R, Coyne T, Saleh J, Wallace MC (1996) The validity of classification for the clinical presentation of intracranial dural arteriovenous fistulas. J Neurosurg 85(5):830–837. https://doi.org/10.3171/jns.1996.85.5.0830
Dawson RC 3rd, Joseph GJ, Owens DS, Barrow DL (1998) Transvenous embolization as the primary therapy for arteriovenous fistulas of the lateral and sigmoid sinuses. AJNR Am J Neuroradiol 19(3):571–576
Delgado Almandoz JE, Schaefer PW, Forero NP, Falla JR, Gonzalez RG, Romero JM (2009) Diagnostic accuracy and yield of multidetector CT angiography in the evaluation of spontaneous intraparenchymal cerebral hemorrhage. AJNR Am J Neuroradiol 30(6):1213–1221. doi:ajnr.A1546 [pii]10.3174/ajnr.A1546
Duffau H, Lopes M, Janosevic V, Sichez JP, Faillot T, Capelle L, Ismail M, Bitar A, Arthuis F, Fohanno D (1999) Early rebleeding from intracranial dural arteriovenous fistulas: report of 20 cases and review of the literature. J Neurosurg 90(1):78–84. https://doi.org/10.3171/jns.1999.90.1.0078
Edlow JA, Newman-Toker DE, Savitz SI (2008) Diagnosis and initial management of cerebellar infarction. Lancet Neurol 7(10):951–964. doi:S1474-4422(08)70216-3 [pii]10.1016/S1474-4422(08)70216-3
Eskander MS, Drew JM, Aubin ME, Marvin J, Franklin PD, Eck JC, Patel N, Boyle K, Connolly PJ (2010) Vertebral artery anatomy: a review of two hundred fifty magnetic resonance imaging scans. Spine (Phila Pa 1976) 35(23):2035–2040. https://doi.org/10.1097/BRS.0b013e3181c9f3d4
Ferbert A, Bruckmann H, Drummen R (1990) Clinical features of proven basilar artery occlusion. Stroke 21(8):1135–1142
Fiorella D, Hsu D, Woo HH, Tarr RW, Nelson PK (2010) Very late thrombosis of a pipeline embolization device construct: case report. Neurosurgery 67(3 Suppl Operative):onsE313–onsE314; discussion onsE314. https://doi.org/10.1227/01.NEU.0000383875.08681.23
Fiorella D, Lylyk P, Szikora I, Kelly ME, Albuquerque FC, McDougall CG, Nelson PK (2009) Curative cerebrovascular reconstruction with the pipeline embolization device: the emergence of definitive endovascular therapy for intracranial aneurysms. J NeuroInterv Surg 1:56–65
Flemming KD, Wiebers DO, Brown RD Jr, Link MJ, Nakatomi H, Huston J 3rd, McClelland R, Christianson TJ (2004) Prospective risk of hemorrhage in patients with vertebrobasilar nonsaccular intracranial aneurysm. J Neurosurg 101(1):82–87. https://doi.org/10.3171/jns.2004.101.1.0082
Garcia Monaco R, Alvarez H, Goulao A, Pruvost P, Lasjaunias P (1990) Posterior fossa arteriovenous malformations. Angioarchitecture in relation to their hemorrhagic episodes. Neuroradiology 31(6):471–475
Glass TA, Hennessey PM, Pazdera L, Chang HM, Wityk RJ, Dewitt LD, Pessin MS, Caplan LR (2002) Outcome at 30 days in the new England Medical Center posterior circulation registry. Arch Neurol 59(3):369–376. doi:noc10124 [pii]
Golshani K, Ferrell A, Zomorodi A, Smith TP, Britz GW (2010) A review of the management of posterior communicating artery aneurysms in the modern era. Surg Neurol Int 1:88. https://doi.org/10.4103/2152-7806.74147
Grand W, Budny JL, Gibbons KJ, Sternau LL, Hopkins LN (1997) Microvascular surgical anatomy of the vertebrobasilar junction. Neurosurgery 40(6):1219–1223. discussion 1223–1215
Hacke W, Zeumer H, Ferbert A, Bruckmann H, del Zoppo GJ (1988) Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebrobasilar occlusive disease. Stroke 19(10):1216–1222
Hamada Y, Goto K, Inoue T, Iwaki T, Matsuno H, Suzuki S, Matsushima T, Fukui M, Miyake E (1997) Histopathological aspects of dural arteriovenous fistulas in the transverse-sigmoid sinus region in nine patients. Neurosurgery 40(3):452–456. discussion 456–458
Hanel RA, Boulos AS, Sauvageau EG, Levy EI, Guterman LR, Hopkins LN (2005) Stent placement for the treatment of nonsaccular aneurysms of the vertebrobasilar system. Neurosurg Focus 18(2):E8. doi:180208 [pii]
Hauck EF, Welch BG, White JA, Purdy PD, Pride LG, Samson D (2009) Preoperative embolization of cerebral arteriovenous malformations with onyx. AJNR Am J Neuroradiol 30(3):492–495. doi:ajnr.A1376 [pii]10.3174/ajnr.A1376
Henkes H, Fischer S, Mariushi W, Weber W, Liebig T, Miloslavski E, Brew S, Kuhne D (2005) Angiographic and clinical results in 316 coil-treated basilar artery bifurcation aneurysms. J Neurosurg 103(6):990–999. https://doi.org/10.3171/jns.2005.103.6.0990
Hernesniemi JA, Dashti R, Juvela S, Vaart K, Niemela M, Laakso A (2008) Natural history of brain arteriovenous malformations: a long-term follow-up study of risk of hemorrhage in 238 patients. Neurosurgery 63(5):823–829; discussion 829–831. doi:10.1227/01.NEU.0000330401.82582.5E00006123-200811000-00002 (pii)
Heros RC (2002) Posterior inferior cerebellar artery. J Neurosurg 97(4):747–748.; discussion 748. https://doi.org/10.3171/jns.2002.97.4.0747
Hornig CR, Rust DS, Busse O, Jauss M, Laun A (1994) Space-occupying cerebellar infarction. Clinical course and prognosis Stroke 25(2):372–374
Jellinger K (1986) Vascular malformations of the central nervous system: a morphological overview. Neurosurg Rev 9(3):177–216
Jensen MB, St Louis EK (2005) Management of acute cerebellar stroke. Arch Neurol 62(4):537–544. doi:62/4/537 [pii]10.1001/archneur.62.4.537
Kader A, Young WL, Pile-Spellman J, Mast H, Sciacca RR, Mohr JP, Stein BM (1994) The influence of hemodynamic and anatomic factors on hemorrhage from cerebral arteriovenous malformations. Neurosurgery 34(5):801–807. discussion 807–808
Kameda W, Kawanami T, Kurita K, Daimon M, Kayama T, Hosoya T, Kato T (2004) Lateral and medial medullary infarction: a comparative analysis of 214 patients. Stroke 35(3):694–699. https://doi.org/10.1161/01.STR.0000117570.41153.3501.STR.0000117570.41153.35. [pii]
Kase CS, Norrving B, Levine SR, Babikian VL, Chodosh EH, Wolf PA, Welch KM (1993) Cerebellar infarction. Clinical and anatomic observations in 66 cases. Stroke 24(1):76–83
Kelly ME, Guzman R, Sinclair J, Bell-Stephens TE, Bower R, Hamilton S, Marks MP, Do HM, Chang SD, Adler JR, Levy RP, Steinberg GK (2008) Multimodality treatment of posterior fossa arteriovenous malformations. J Neurosurg 108(6):1152–1161. https://doi.org/10.3171/JNS/2008/108/6/1152
Khaw AV, Mohr JP, Sciacca RR, Schumacher HC, Hartmann A, Pile-Spellman J, Mast H, Stapf C (2004) Association of infratentorial brain arteriovenous malformations with hemorrhage at initial presentation. Stroke 35(3):660–663. https://doi.org/10.1161/01.STR.0000117093.59726.F901.STR.0000117093.59726.F9. [pii]
Khayata MH, Zabramski JM, Johnson PC, Flom R (1993) False aneurysm associated with rupture of an arteriovenous malformation–implications for treatment: case report. Neurosurgery 33(4):753–756
Kim DJ, terBrugge K, Krings T, Willinsky R, Wallace C (2010) Spontaneous angiographic conversion of intracranial dural arteriovenous shunt: long-term follow-up in nontreated patients. Stroke 41(7):1489–1494. doi:STROKEAHA.110.581462 [pii]10.1161/STROKEAHA.110.581462
Kim JS (2003) Pure lateral medullary infarction: clinical-radiological correlation of 130 acute, consecutive patients. Brain 126(Pt 8):1864–1872. https://doi.org/10.1093/brain/awg169awg169. [pii]
Kim JS, Han YS (2009) Medial medullary infarction: clinical, imaging, and outcome study in 86 consecutive patients. Stroke 40(10):3221–3225. doi:STROKEAHA.109.559864 [pii]10.1161/STROKEAHA.109.559864
Kim JS, Kim J (2005) Pure midbrain infarction: clinical, radiologic, and pathophysiologic findings. Neurology 64(7):1227–1232. doi:64/7/1227 [pii]10.1212/01.WNL.0000156520.46056.6B
Kiran NA, Kale SS, Kasliwal MK, Vaishya S, Gupta A, Singh Sharma M, Shankar Sharma B, Kumar Mahapatra A (2009) Gamma knife radiosurgery for arteriovenous malformations of basal ganglia, thalamus and brainstem-a retrospective study comparing the results with that for AVMs at other intracranial locations. Acta Neurochir 151(12):1575–1582. https://doi.org/10.1007/s00701-009-0335-0
Kiyosue H, Hori Y, Okahara M, Tanoue S, Sagara Y, Matsumoto S, Nagatomi H, Mori H (2004) Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization. Radiographics 24(6):1637–1653. doi:24/6/1637 [pii]10.1148/rg.246045026
Kubik CS, Adams RD (1946) Occlusion of the basilar artery; a clinical and pathological study. Brain 69(2):73–121
Kumral E, Afsar N, Kirbas D, Balkir K, Ozdemirkiran T (2002a) Spectrum of medial medullary infarction: clinical and magnetic resonance imaging findings. J Neurol 249(1):85–93
Kumral E, Bayulkem G, Akyol A, Yunten N, Sirin H, Sagduyu A (2002b) Mesencephalic and associated posterior circulation infarcts. Stroke 33(9):2224–2231
Kumral E, Bayulkem G, Evyapan D (2002c) Clinical spectrum of pontine infarction. Clinical-MRI correlations J Neurol 249(12):1659–1670. https://doi.org/10.1007/s00415-002-0879-x
Kumral E, Kisabay A, Atac C (2005a) Lesion patterns and etiology of ischemia in superior cerebellar artery territory infarcts. Cerebrovasc Dis 19(5):283–290. doi:CED2005019005283 [pii]10.1159/000084496
Kumral E, Kisabay A, Atac C, Calli C, Yunten N (2005b) Spectrum of the posterior inferior cerebellar artery territory infarcts. Clinical-diffusion-weighted imaging correlates. Cerebrovasc Dis 20(5):370–380. doi:CED2005020005370 [pii]10.1159/000088667
Kurita H, Kawamoto S, Sasaki T, Shin M, Tago M, Terahara A, Ueki K, Kirino T (2000) Results of radiosurgery for brain stem arteriovenous malformations. J Neurol Neurosurg Psychiatry 68(5):563–570
Lasjaunias P (2001) Surgical neuroangiography: clinical anatomy and variations. Volume 1 clinical vascular anatomy and variations. Springer, Berlin
Lawton MT, Sanchez-Mejia RO, Pham D, Tan J, Halbach VV (2008) Tentorial dural arteriovenous fistulae: operative strategies and microsurgical results for six types. Neurosurgery 62(3 Suppl 1):110–124; discussion 124-115. https://doi.org/10.1227/01.neu.0000317381.68561.b000006123-200803001-00015 [pii]
Lee H, Kim JS, Chung EJ, Yi HA, Chung IS, Lee SR, Shin JY (2009) Infarction in the territory of anterior inferior cerebellar artery: spectrum of audiovestibular loss. Stroke 40(12):3745–3751. doi:STROKEAHA.109.564682 [pii]10.1161/STROKEAHA.109.564682
Lev MH, Farkas J, Rodriguez VR, Schwamm LH, Hunter GJ, Putman CM, Rordorf GA, Buonanno FS, Budzik R, Koroshetz WJ, Gonzalez RG (2001) CT angiography in the rapid triage of patients with hyperacute stroke to intraarterial thrombolysis: accuracy in the detection of large vessel thrombus. J Comput Assist Tomogr 25(4):520–528. doi:00004728-200107000-00003 [pii]
Lewis SB, Chang DJ, Peace DA, Lafrentz PJ, Day AL (2002) Distal posterior inferior cerebellar artery aneurysms: clinical features and management. J Neurosurg 97(4):756–766. https://doi.org/10.3171/jns.2002.97.4.0756
Li Q, Lv F, Li Y, Luo T, Li K, Xie P (2009) Evaluation of 64-section CT angiography for detection and treatment planning of intracranial aneurysms by using DSA and surgical findings. Radiology 252(3):808–815. doi:2523081911 [pii]10.1148/radiol.2523081911
Lindsberg PJ, Mattle HP (2006) Therapy of basilar artery occlusion: a systematic analysis comparing intra-arterial and intravenous thrombolysis. Stroke 37(3):922–928. doi:01.STR.0000202582.29510.6b [pii]10.1161/01.STR.0000202582.29510.6b
Lou M, Caplan LR (2010) Vertebrobasilar dilatative arteriopathy (dolichoectasia). Ann N Y Acad Sci 1184:121–133. doi:NYAS5114 [pii]10.1111/j.1749-6632.2009.05114.x
Lozier AP, Connolly ES Jr, Lavine SD, Solomon RA (2002) Guglielmi detachable coil embolization of posterior circulation aneurysms: a systematic review of the literature. Stroke 33(10):2509–2518
Lubicz B, Levivier M, Francois O, Thoma P, Sadeghi N, Collignon L, Baleriaux D (2007) Sixty-four-row multisection CT angiography for detection and evaluation of ruptured intracranial aneurysms: interobserver and intertechnique reproducibility. AJNR Am J Neuroradiol 28(10):1949–1955. doi:ajnr.A0699 [pii]10.3174/ajnr.A0699
Luciani A, Houdart E, Mounayer C, Saint Maurice JP, Merland JJ (2001) Spontaneous closure of dural arteriovenous fistulas: report of three cases and review of the literature. AJNR Am J Neuroradiol 22(5):992–996
Lv X, Jiang C, Zhang J, Li Y, Wu Z (2009) Complications related to percutaneous transarterial embolization of intracranial dural arteriovenous fistulas in 40 patients. AJNR Am J Neuroradiol 30(3):462–468. doi:ajnr.A1419 [pii]10.3174/ajnr.A1419
Macdonald JH, Millar JS, Barker CS (2010) Endovascular treatment of cranial dural arteriovenous fistulae: a single-Centre, 14-year experience and the impact of Onyx on local practise. Neuroradiology 52(5):387–395. https://doi.org/10.1007/s00234-009-0620-x
Macdonell RA, Kalnins RM, Donnan GA (1987) Cerebellar infarction: natural history, prognosis, and pathology. Stroke 18(5):849–855
Mangrum WI, Huston J 3rd, Link MJ, Wiebers DO, McClelland RL, Christianson TJ, Flemming KD (2005) Enlarging vertebrobasilar nonsaccular intracranial aneurysms: frequency, predictors, and clinical outcome of growth. J Neurosurg 102(1):72–79. doi:10.3171.jns.2005.102.1.0072
Marinkovic SV, Gibo H (1993) The surgical anatomy of the perforating branches of the basilar artery. Neurosurgery 33(1):80–87
Martin PJ, Chang HM, Wityk R, Caplan LR (1998) Midbrain infarction: associations and aetiologies in the new England Medical Center posterior circulation registry. J Neurol Neurosurg Psychiatry 64(3):392–395
Mizutani T, Aruga T, Kirino T, Miki Y, Saito I, Tsuchida T (1995) Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar dissecting aneurysms. Neurosurgery 36(5):905–911; discussion 912-903
Mizutani T, Miki Y, Kojima H, Suzuki H (1999) Proposed classification of nonatherosclerotic cerebral fusiform and dissecting aneurysms. Neurosurgery 45(2):253–259; discussion 259–260
Mohr JP, Moskowitz AJ, Stapf C, Hartmann A, Lord K, Marshall SM, Mast H, Moquete E, Moy CS, Parides M, Pile-Spellman J, Al-Shahi Salman R, Weinberg A, Young WL, Estevez A, Kureshi I, Brisman JL (2010) The ARUBA trial: current status, future hopes. Stroke 41(8):e537–e540. doi:STROKEAHA.110.580274 [pii]10.1161/STROKEAHA.110.580274
Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R (2002) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360(9342):1267–1274
Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P (2005) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366(9488):809–817. doi:S0140-6736(05)67214-5 [pii]10.1016/S0140-6736(05)67214-5
Natarajan SK, Ghodke B, Kim LJ, Hallam DK, Britz GW, Sekhar LN (2010) Multimodality treatment of intracranial dural arteriovenous fistulas in the Onyx era: a single center experience. World Neurosurg 73(4):365–379. doi:S1878-8750(10)00010-0 [pii]10.1016/j.wneu.2010.01.009
Newton TH, Cronqvist S (1969) Involvement of dural arteries in intracranial arteriovenous malformations. Radiology 93(5):1071–1078
O’Shaughnessy BA, Getch CC, Bendok BR, Batjer HH (2005) Microsurgical resection of infratentorial arteriovenous malformations. Neurosurg Focus 19(2):E5. doi:190205 [pii]
Ogilvy CS, Stieg PE, Awad I, Brown RD Jr, Kondziolka D, Rosenwasser R, Young WL, Hademenos G (2001) Recommendations for the management of intracranial arteriovenous malformations: a statement for healthcare professionals from a special writing group of the stroke council, American Stroke Association. Circulation 103(21):2644–2657
Pai BS, Varma RG, Kulkarni RN, Nirmala S, Manjunath LC, Rakshith S (2007) Microsurgical anatomy of the posterior circulation. Neurol India 55(1):31–41
Panagiotopoulos V, Gizewski E, Asgari S, Regel J, Forsting M, Wanke I (2009) Embolization of intracranial arteriovenous malformations with ethylene-vinyl alcohol copolymer (Onyx). AJNR Am J Neuroradiol 30(1):99–106. doi:ajnr.A1314 [pii]10.3174/ajnr.A1314
Peluso JP, van Rooij WJ, Sluzewski M, Beute GN (2007a) Distal aneurysms of cerebellar arteries: incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. AJNR Am J Neuroradiol 28(8):1573–1578. doi:28/8/1573 [pii]10.3174/ajnr.A0607
Peluso JP, van Rooij WJ, Sluzewski M, Beute GN (2007b) Superior cerebellar artery aneurysms: incidence, clinical presentation and midterm outcome of endovascular treatment. Neuroradiology 49(9):747–751. https://doi.org/10.1007/s00234-007-0251-z
Peluso JP, van Rooij WJ, Sluzewski M, Beute GN, Majoie CB (2008) Posterior inferior cerebellar artery aneurysms: incidence, clinical presentation, and outcome of endovascular treatment. AJNR Am J Neuroradiol 29(1):86–90. doi:ajnr.A0758 [pii]10.3174/ajnr.A0758
Perret G, Nishioka H (1966) Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study. J Neurosurg 25(4):467–490. https://doi.org/10.3171/jns.1966.25.4.0467
Pfefferkorn T, Eppinger U, Linn J, Birnbaum T, Herzog J, Straube A, Dichgans M, Grau S (2009) Long-term outcome after suboccipital decompressive craniectomy for malignant cerebellar infarction. Stroke 40(9):3045–3050. doi:STROKEAHA.109.550871 [pii]10.1161/STROKEAHA.109.550871
Pico F, Labreuche J, Touboul PJ, Amarenco P (2003) Intracranial arterial dolichoectasia and its relation with atherosclerosis and stroke subtype. Neurology 61(12):1736–1742
Pierot L, Chiras J, Meder JF, Rose M, Rivierez M, Marsault C (1992) Dural arteriovenous fistulas of the posterior fossa draining into subarachnoid veins. AJNR Am J Neuroradiol 13(1):315–323
Prokop M, Shin HO, Schanz A, Schaefer-Prokop CM (1997) Use of maximum intensity projections in CT angiography: a basic review. Radiographics 17(2):433–451
Raaymakers TW, Rinkel GJ, Limburg M, Algra A (1998) Mortality and morbidity of surgery for unruptured intracranial aneurysms: a meta-analysis. Stroke 29(8):1531–1538
Rhoton AL Jr (2000) The cerebellar arteries. Neurosurgery 47(3 Suppl):S29–S68
Rhoton AL Jr (2002) Aneurysms. Neurosurgery 51(4 Suppl):S121–S158
Rinkel GJ, van Gijn J, Wijdicks EF (1993) Subarachnoid hemorrhage without detectable aneurysm. A review of the causes Stroke 24(9):1403–1409
Rinkel GJ, Wijdicks EF, Vermeulen M, Ramos LM, Tanghe HL, Hasan D, Meiners LC, van Gijn J (1991) Nonaneurysmal perimesencephalic subarachnoid hemorrhage: CT and MR patterns that differ from aneurysmal rupture. AJNR Am J Neuroradiol 12(5):829–834
Romero JM, Artunduaga M, Forero NP, Delgado J, Sarfaraz K, Goldstein JN, Gonzalez RG, Schaefer PW (2009) Accuracy of CT angiography for the diagnosis of vascular abnormalities causing intraparenchymal hemorrhage in young patients. Emerg Radiol 16(3):195–201. https://doi.org/10.1007/s10140-008-0785-3
Saba L, Mallarin G (2009) Window settings for the study of calcified carotid plaques with multidetector CT angiography. AJNR Am J Neuroradiol 30(7):1445–1450. doi:ajnr.A1509 [pii]10.3174/ajnr.A1509
Saeki N, Rhoton AL Jr (1977) Microsurgical anatomy of the upper basilar artery and the posterior circle of Willis. J Neurosurg 46(5):563–578. https://doi.org/10.3171/jns.1977.46.5.0563
Sanai N, Tarapore P, Lee AC, Lawton MT (2008) The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era. Neurosurgery 62(6):1236–1249; discussion 1249–1253. https://doi.org/10.1227/01.neu.0000333295.59738.de00006123-200806000-00011 [pii]
Savitz SI, Caplan LR (2005) Vertebrobasilar disease. N Engl J Med 352(25):2618–2626. doi:352/25/2618 [pii]10.1056/NEJMra041544
Schievink WI, Wijdicks EF, Piepgras DG, Chu CP, O’Fallon WM, Whisnant JP (1995) The poor prognosis of ruptured intracranial aneurysms of the posterior circulation. J Neurosurg 82(5):791–795. https://doi.org/10.3171/jns.1995.82.5.0791
Schonewille WJ, Wijman CA, Michel P, Rueckert CM, Weimar C, Mattle HP, Engelter ST, Tanne D, Muir KW, Molina CA, Thijs V, Audebert H, Pfefferkorn T, Szabo K, Lindsberg PJ, de Freitas G, Kappelle LJ, Algra A (2009) Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (BASICS): a prospective registry study. Lancet Neurol 8(8):724–730. doi:S1474-4422(09)70173-5 [pii]10.1016/S1474-4422(09)70173-5
Schuster JM, Santiago P, Elliott JP, Grady MS, Newell DW, Winn HR (1999) Acute traumatic posteroinferior cerebellar artery aneurysms: report of three cases. Neurosurgery 45(6):1465–1467. discussion 1467–1468
Seo SW, Heo JH, Lee KY, Shin WC, Chang DI, Kim SM, Heo K (2001) Localization of Claude’s syndrome. Neurology 57(12):2304–2307
Sinclair J, Kelly ME, Steinberg GK (2006) Surgical management of posterior fossa arteriovenous malformations. Neurosurgery 58(4 Suppl 2): ONS-189-201; discussion ONS-201. https://doi.org/10.1227/01.NEU.0000204641.38419.2D00006123-200604002-00001 [pii]
Singh V, Smith WS, Lawton MT, Halbach VV, Young WL (2008) Risk factors for hemorrhagic presentation in patients with dural arteriovenous fistulae. Neurosurgery 62(3):628–635; discussion 628–635. https://doi.org/10.1227/01.neu.0000317311.69697.fc00006123-200803000-00010. [pii]
Smith WS (2007) Intra-arterial thrombolytic therapy for acute basilar occlusion: pro. Stroke 38(2 Suppl):701–703. doi:38/2/701 [pii]10.1161/01.STR.0000247897.33267.42
Soeda A, Sakai N, Sakai H, Iihara K, Nagata I (2004) Endovascular treatment of asymptomatic cerebral aneurysms: anatomic and technical factors related to ischemic events and coil stabilization. Neurol Med Chir (Tokyo) 44(9):456–465; discussion 466. doi:JST.JSTAGE/nmc/44.456 [pii]
Sohn SI, Lee H, Lee SR, Baloh RW (2006) Cerebellar infarction in the territory of the medial branch of the superior cerebellar artery. Neurology 66(1):115–117. doi:66/1/115 [pii]10.1212/01.wnl.0000191389.81651.de
Spetzler RF, Martin NA (1986) A proposed grading system for arteriovenous malformations. J Neurosurg 65(4):476–483. https://doi.org/10.3171/jns.1986.65.4.0476
Stefani MA, Porter PJ, terBrugge KG, Montanera W, Willinsky RA, Wallace MC (2002) Angioarchitectural factors present in brain arteriovenous malformations associated with hemorrhagic presentation. Stroke 33(4):920–924
Steinberg GK, Drake CG, Peerless SJ (1993) Deliberate basilar or vertebral artery occlusion in the treatment of intracranial aneurysms. Immediate results and long-term outcome in 201 patients. J Neurosurg 79(2):161–173. https://doi.org/10.3171/jns.1993.79.2.0161
Stiefel MF, Albuquerque FC, Park MS, Dashti SR, McDougall CG (2009) Endovascular treatment of intracranial dural arteriovenous fistulae using Onyx: a case series. Neurosurgery 65(6 Suppl):132–139; discussion 139–140. https://doi.org/10.1227/01.NEU.0000345949.41138.0100006123-200912001-00016 [pii]
Symon L, Tacconi L, Mendoza N, Nakaji P (1995) Arteriovenous malformations of the posterior fossa: a report on 28 cases and review of the literature. Br J Neurosurg 9(6):721–732
Thrift AG, Donnan GA, McNeil JJ (1995) Epidemiology of intracerebral hemorrhage. Epidemiol Rev 17(2):361–381
Tohgi H, Takahashi S, Chiba K, Hirata Y (1993) Cerebellar infarction. Clinical and neuroimaging analysis in 293 patients. The Tohoku cerebellar infarction study group. Stroke 24(11):1697–1701
Tomanek AI, Coutts SB, Demchuk AM, Hudon ME, Morrish WE, Sevick RJ, Simon JE, Frayne R, Buchan AM, Hill MD (2006) MR angiography compared to conventional selective angiography in acute stroke. Can J Neurol Sci 33(1):58–62
Turjman F, Massoud TF, Vinuela F, Sayre JW, Guglielmi G, Duckwiler G (1995) Correlation of the angioarchitectural features of cerebral arteriovenous malformations with clinical presentation of hemorrhage. Neurosurgery 37(5):856–860, discussion 860-852
Turney TM, Garraway WM, Whisnant JP (1984) The natural history of hemispheric and brainstem infarction in Rochester, Minnesota. Stroke 15(5):790–794
Urban PP, Marx J, Hunsche S, Gawehn J, Vucurevic G, Wicht S, Massinger C, Stoeter P, Hopf HC (2003) Cerebellar speech representation: lesion topography in dysarthria as derived from cerebellar ischemia and functional magnetic resonance imaging. Arch Neurol 60(7):965–972. https://doi.org/10.1001/archneur.60.7.96560/7/965. [pii]
van Dijk JM, terBrugge KG, Willinsky RA, Wallace MC (2002) Clinical course of cranial dural arteriovenous fistulas with long-term persistent cortical venous reflux. Stroke 33(5):1233–1236
van Rooij WJ, Sluzewski M, Beute GN (2007) Brain AVM embolization with Onyx. Am J Neuroradiol 28(1):172–177; discussion 178. doi:28/1/172 [pii]
Velthuis BK, Rinkel GJ, Ramos LM, Witkamp TD, van Leeuwen MS (1999) Perimesencephalic hemorrhage. Exclusion of vertebrobasilar aneurysms with CT angiography. Stroke 30(5):1103–1109
Vemmos KN, Spengos K, Tsivgoulis G, Manios E, Zis V, Vassilopoulos D (2005) Aetiopathogenesis and long-term outcome of isolated pontine infarcts. J Neurol 252(2):212–217. https://doi.org/10.1007/s00415-005-0639-9
Weimar C, Goertler M, Harms L, Diener HC (2006) Distribution and outcome of symptomatic stenoses and occlusions in patients with acute cerebral ischemia. Arch Neurol 63(9):1287–1291. doi:63/9/1287 [pii]10.1001/archneur.63.9.1287
Wiebers DO, Whisnant JP, Huston J 3rd, Meissner I, Brown RD Jr, Piepgras DG, Forbes GS, Thielen K, Nichols D, O’Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable-Beckman GL, Torner JC (2003) Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362(9378):103–110. doi:S0140673603138603 [pii]
Wu HM, Pan DH, Chung WY, Guo WY, Liu KD, Shiau CY, Wang LW, Chen SJ (2006) Gamma knife surgery for the management of intracranial dural arteriovenous fistulas. J Neurosurg 105(Suppl):43–51. https://doi.org/10.3171/sup.2006.105.7.43
Zhu XL, Chan MS, Poon WS (1997) Stroke 28(7):1406–1409
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Chaudhry, Z.A., Chandra, R.V., González, R.G., Yoo, A.J. (2022). Imaging Vascular Anatomy and Pathology of the Posterior Fossa. In: Manto, M.U., Gruol, D.L., Schmahmann, J.D., Koibuchi, N., Sillitoe, R.V. (eds) Handbook of the Cerebellum and Cerebellar Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-23810-0_28
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