Posterior Cerebral Artery Aneurysm Research Articles

Thromboembolic Events in the Posterior Circulation After Flow Diversion—A Closer Look at Coverage of the Posterior Cerebral Artery

Flow diversion (FD) for bifurcation aneurysms requires excluding one of the branches from the parent artery, raising concern for ischemic events. Herein, we evaluate thromboembolic events and their relation with covering the origin of the posterior cerebral artery (PCA). This retrospective analysis included patients with confirmed basilar and proximal PCA aneurysms treated with FD between 2013 to 2023. Procedures were classified according to the coverage of the origin of the PCA. Thromboembolic events associated with the excluded PCA were evaluated. Out of the total 28 aneurysms included, 7 were at the basilar-tip, 16 in the basilar trunk, and 5 in the P1-segment; fifteen were treated excluding one of the PCA. DAPT included aspirin-ticagrelor (57.1%), aspirin-clopidogrel (35.7%), and aspirin-prasugrel (3.57%). Complete and near-complete aneurysm occlusion was achieved in 80.8% of aneurysms treated in a median follow-up of 12.31 months. Thromboembolic complications occurred in three patients, two basilar perforator stroke and one basilar in stent thrombosis; but there was no statistically significant difference in these events between patients with PCA coverage and those without (p=0.46). Diminished and lack of flow was seen in eight and seven of the covered vessels. mRS≤2 was reported in 89.3% of patients in a median clinical follow-up of 5.5 months. Thromboembolic events are high in distal basilar and proximal PCA aneurysms, but PCA coverage was not associated with their occurrence. There was no difference in post-procedural disability between patients whose aneurysms were treated excluding one of the PCAs, and those who did not.

Combined Open Surgical and Endovascular Management of a Giant Posterior Cerebral Artery Aneurysm: 2-Dimensional Operative Video.

A 17-year-old female patient presented with worsening intractable headaches which were initially diagnosed as migraine headaches. The patient's headaches were refractory to medical management and continued to worsen in both severity and frequency. Computed tomography angiography and digital subtraction angiography demonstrated a giant posterior cerebral artery aneurysm with contributions from the internal carotid artery through the posterior communicating artery. During the surgical planning period, the patient continued to have worsening headaches, intractable nausea, vomiting, left upper extremity weakness, and associated visual obfuscations. Repeated angiography revealed spontaneous thrombosis of the posterior communicating artery contribution with additional sudden onset hemianopsia on balloon test occlusion of the posterior cerebral artery, prompting urgent surgical intervention. A right subtemporal approach was used for a superficial temporal artery to posterior cerebral artery bypass, followed by coil occlusion of the aneurysm inlet at the posterior cerebral artery on postoperative day 1. The patient consented to the procedure. Postoperative angiography demonstrated successful superficial temporal artery to posterior cerebral artery anastomosis with occluded posterior cerebral artery after coiling. At 1-year follow-up, the patient remained neurologically intact with a patent bypass and regression of the trapped aneurysm. We present this case to demonstrate the successful management of a complex posterior cerebral artery aneurysm with both surgical bypass and endovascular parent artery coil occlusion.1-6.

Posterior Cerebral Artery–to–Superior Cerebellar Artery Side-to-Side Bypass via Extreme Lateral Supracerebellar Infratentorial Approach: Technical Note

Background and objectiveDifficult-to-treat aneurysms of the distal posterior cerebral artery (PCA) can often be treated by parent artery occlusion. A cerebrovascular bypass can complement PCA occlusion to curb the risk of ischemic complications.An in-situ bypass may be considered when the occipital artery or superficial temporal artery cannot serve as a bypass donor.This paper describes the use of a side-to-side bypass of superior cerebellar artery (SCA) as a donor to the posterior cerebral artery (PCA) via an extreme lateral supracerebellar infratentorial (ELSCIT) approach. This bypass approach can be a useful surgical strategy for PCA revascularization. MethodsA 40-year-old female patient underwent a side-to-side PCA-SCA bypass via the ELSCIT approach for the treatment of a complex and previously coiled PCA aneurysm.Bypass was followed by endovascular aneurysm and parent artery occlusion. ResultsPostoperatively, the patient experienced transient, partial trochlear nerve palsy of the left eye without ischemic lesions on MRI. The clinical condition was stable and angiography showed a patent bypass and complete aneurysm occlusion 12 months after surgery. ConclusionThe ELSCIT-approach offers access to the medial and distal PCA that is well suitable for a side-to-side PCA-SCA bypass. This type of approach and bypass may be of value when revascularization of a P2-P3 portion of the PCA is needed, but a suitable occipital artery (OA) or superficial temporal artery (STA) is not available.

Trans-lateral ventricular approach for surgical treatment of high-located P2–P3 junction posterior cerebral artery aneurysms: from anatomical research to clinical application

BackgroundPosterior cerebral artery (PCA) aneurysms, though rare, pose treatment challenges. Endovascular therapy is the preferred option, but microsurgery becomes necessary in certain cases. Various microsurgical approaches have been suggested for PCA aneurysms, particularly those at the P2–P3 junction. This study highlights the trans-lateral ventricular approach (TVA) for addressing these complex aneurysms. This study aims to assess the feasibility and safety of the trans-lateral ventricular approach (TVA) for treating high-located complex PCA aneurysms at the P2–P3 junction. The study evaluates both clinical outcomes and anatomical considerations.MethodsTwo cases of PCA aneurysms at the P2–P3 junction were treated using TVA in 2019. Navigation-guided entry via the interparietal sulcus was planned. Ventriculostomy was performed from the cortex to the lateral ventricle’s atrium. Medial atrial floor dissection exposed PCA’s P2–P3 segments. Neuronavigation and ultrasound-aided guidance was used. Anatomical studies on fixed and contrast-perfused specimens refined the approach.ResultsBoth cases saw successful aneurysm clipping. The unruptured aneurysm patient was discharged in 6 days. The poor-grade SAH patient required extended ICU care, moving to rehabilitation with mRS = 4. The unruptured complex aneurysm case exhibited no deficits, returning to work in 3 months. Anatomical dissections validated TVA for high-located P2–P3 junction PCA aneurysms.ConclusionWhile endovascular therapy remains primary, this study demonstrates the viability of navigation-guided TVA for select high-located P2–P3 junction PCA aneurysms. Successes and challenges underscore the importance of patient selection and anatomical awareness.

Isolated ipsilateral abducens nerve palsy and contralateral homonymous hemianopsia associated with unruptured posterior cerebral artery aneurysm: A rare neurological finding.

Cranial nerve palsies can be presenting signs of intracranial aneurysms. There is a classic pairing between an aneurysmal vessel and adjacent nerves leading to cranial neuropathy. Isolated abducens nerve palsy can be a localizing sign of an unruptured vertebrobasilar circulation aneurysm. Aneurysms involving Anterior Inferior Cerebellar Artery (AICA) and Posterior Inferior Cerebellar Artery (PICA) have been reported to be associated with abducens nerve palsy. The symptoms in unruptured aneurysms are due to the mass effect on adjacent neurovascular structures. Most of the abducens nerve palsy resolves following microsurgical clipping. Here, we present a rare case of an unruptured Posterior Cerebral Artery (PCA) aneurysm presenting with abducens nerve palsy and diplopia associated with contralateral hemianopsia which markedly improved following endovascular coil embolization.

Endovascular Treatment in Precommunicating Segment Aneurysms of Posterior Cerebral Artery

Pre-communicating (P1) segment aneurysms of the posterior cerebral artery (PCA) are rare, with few studies reported to date. Herein, we address the clinical and radiologic outcomes of their endovascular treatment. For this study, we retrieved prospectively collected data on 35 consecutive patients with 37 P1 aneurysms, analyzing the clinical ramifications and morphologic outcomes of treatment. All subjects received endovascular interventions between January 2001 and October 2021. There were 16 aneurysms (43.2%) of P1 segment sidewalls and 21 (56.8%) at P1/posterior communicating artery (PCoA) junctions. Five (13.5%) were fusiform, and 14 (37.8%) were ruptured. In 14 patients (40%), 16 aneurysms (43%) were associated with intracranial arterial occlusive disease of the anterior circulation. Selective coiling was undertaken in 34 aneurysms (91.9%), using single (n=24) or double (n=4) microcatheters, microcatheter protection (n=2), or stents (n=4); and trapping was done in 3 (8.1%). No procedure-related morbidity or mortality resulted. Excluding the trapped lesions, angiographic follow-up of 29 aneurysms obtained >6 months after embolization (mean, 12.4 month) revealed stable occlusion in 21 (72.4%), with some recanalization in the other 8 (minor: 3/29, 10.4%; major: 5/29, 17.2%). Aneurysms of P1 segment (vs other locations) are strongly associated with intracranial arterial occlusive disease of the anterior circulation and thus are likely flow related. Endovascular treatment of such lesions seems safe and efficacious, despite the array of technical strategies that their distinctive anatomic configurations impose.

Dissecting Aneurysm of the Posterior Cerebral Artery

Posterior circulation aneurysms are more likely to rupture than those in the anterior circulation but also pose more of a challenge for endovascular treatment or neurosurgical clipping. Aneurysms arising from the posterior cerebral artery are rare; dissecting aneurysms are even rarer. Dissecting posterior cerebral artery aneurysms can be spontaneous or post traumatic. Our case depicts a patient with acute subarachnoid hemorrhage due to a ruptured, dissecting posterior cerebral artery aneurysm who underwent successful endovascular treatment by means of flow diversion.

How I do it? Preoperative Microsoft HoloLens 2 planning-assisted surgical clipping of a fetal posterior cerebral artery aneurysm.

The treatment of intracranial aneurysms has predominantly shifted towards endovascular strategies, but complex cases still necessitate microsurgery. Preoperative stimulation can be beneficial for inexperienced young neurosurgeons in preparing for safe microsurgery. A 72-year-old female with a left irregular fetal posterior cerebral artery (PCA) aneurysm underwent clipping repair. Microsoft HoloLens 2, utilizing mixed reality technology, was employed for preoperative stimulation and anatomical study. During the operation, we successfully identified the planned relationship between the aneurysm and the fetal PCA. The patient was cured without any complications. We hope that this report will highlight the significance of Microsoft HoloLens 2 in microsurgical planning and education.

Management of a Rare Case of Moyamoya Disease Associated With Left Posterior Cerebral Artery Aneurysm

Background: The association of moyamoya disease and posterior cerebral artery aneurysms is relatively rare and the prognosis is poor. The management is extremely challenging for neurosurgeons. Case Report: We report a case of a 58-year-old man with a history of moyamoya disease who admitted complaining of sudden-onset headaches, vomiting, and seizure and the investigations revealed a subarachnoid hemorrhage, intracerebral hematoma, posterior cerebral artery aneurysms on a moyamoya disease field. The patient was treated surgically by the clipping of the aneurysm, but developed three days later a complication of the MMD and died. Conclusion: The prognosis of this association is very poor, explain the fact that a therapeutic strategy should be done to reduce the mortality and to determine the best management which is surgery versus embolization and revascularization.

Bilateral Hypoplasia of the Internal Carotid Artery with Subarachnoid Hemorrhage and Distal Posterior Cerebral Artery Aneurysm

Bilateral Hypoplasia of the Internal Carotid Artery with Subarachnoid Hemorrhage and Distal Posterior Cerebral Artery Aneurysm

Spontaneous thrombolysis of an unruptured intracranial aneurysm with spontaneous thrombosis

Background: Spontaneous thrombolysis of unruptured intracranial aneurysm with spontaneous thrombosis is rare and its significance remains unclear. To date, there are no published reports of spontaneous thrombolysis prior to growth of unruptured intracranial aneurysm with spontaneous thrombosis. Methods: We described a 65-year-old man with a chief complaint of mild weakness and numbness in the left limbs. He had a smoking history of 20 years. Then he was diagnosed having unruptured intracranial aneurysm with spontaneous thrombosis. His cerebrovascular digital subtraction angiography conducted 30 days after his first onset revealed spontaneous thrombolysis of the unruptured intracranial aneurysm. And his following brain computed tomography scan conducted 36 days after his first onset revealed growth of the unruptured intracranial aneurysm. Results: The diagnosis of unruptured right fetal-type posterior cerebral artery aneurysm with spontaneous complete thrombosis was established based on the preliminary physical examination and the imaging findings. The patient underwent embolization of the aneurysm and parent artery. We followed up with the patient for 12 months after his embolization of the aneurysm and parent artery. He experienced neither aneurysm recurrence nor cerebral infarction during this period, but his were not alleviated. Conclusion: Spontaneous thrombolysis after spontaneous thrombosis of unruptured intracranial aneurysm is an urgent indication for isolation of the aneurysm, as it may foreshadow the growth of unruptured intracranial aneurysm.

Natural history and management of posterior cerebral artery aneurysms: a systematic review and meta-analysis of individual patient data.

We conducted a comprehensive review and meta-analysis to investigate clinical, radiographic characteristics, and treatment outcomes of posterior cerebral artery aneurysms (PCAA). We systematically reviewed English-language articles investigating available treatments (parent artery occlusion (PAO), microsurgery, reconstructive endovascular (rEVT), and conservative treatments) for PCAA and analyzed the based on aneurysm morphology and rupture status. Six-hundred-eighty-five patients with 698 PCAA were identified from 59 studies. Overall, 371 (54.2%) aneurysms were ruptured, 325 (49%) were saccular, and 342 (51%) were non-saccular aneurysms. The mean age of the saccular was lower (40years) than non-saccular aneurysm group (50years) (P < .05). In ruptured PCAA, favorable clinical outcomes were comparable between the treatment groups except for patients treated conservatively, which had lower rates of favorable clinical outcomes (35.6%) and higher mortality (55.7%) (P < .0001). Ruptured aneurysms treated with rEVT (22.6%) had the highest recanalization rates compared to PAO (9.2%, P = 0.0001) and microsurgery (3.8%, P = 0.005). In unruptured PCAA, clinical outcomes were similar; higher complication rates were noted in microsurgery (40.4%, P = 0.026) and PAO (21.5%, P = 0.015) compared to rEVT (13.2%), which had higher recanalization rates (15.6%, P < .0001). The rates of subsequent stroke following PAO were 21.8% for unruptured and 32.3% for ruptured PCAA (P = 0.078). Ruptured PCAA portend worse prognosis and typically require an intervention to achieve better outcome whereas the benefit of an intervention in unruptured PCAA is much less clear. rEVT is promising for PCAA management with a good clinical and safety profile but more recurrence compared to PAO and microsurgery.

Bypass surgery for ruptured dissecting aneurysms of the proximal posterior cerebral artery: illustrative case.

BACKGROUNDPosterior cerebral artery (PCA) dissecting aneurysms commonly occur in the proximal PCA and are considered rare. The treatment of proximal PCA dissecting aneurysms is challenging because of the existence of perforators supplying the vital neural structures. Recently, endovascular intervention has been used; however, concerns for ischemic or hemorrhagic complications exist.OBSERVATIONSA 54-year-old woman presented with subarachnoid hemorrhage due to dissecting aneurysm rupture at the P1-P2 junction of the PCA. The thalamoperforating artery (TPA) and medial posterior choroidal artery (MPchA) originated from the proximal end and the distal end of the aneurysm, respectively. Additionally, the posterior communicating artery (PcomA) connected with the dissected segment. To preserve these perforators, we performed surgical trapping combined with superficial temporal artery (STA) PCA anastomosis. Clips were applied for trapping the proximal and distal end of the aneurysm, with preservation of the TPA and MPchA origin. PcomA was left open for blood flow preservation to the perforators directly arising from the aneurysm. The postoperative course was uneventful, and the patient was discharged.LESSONSSurgical trapping using STA-PCA bypass could be a treatment of choice for proximal PCA dissecting aneurysms, considering its potential for cure and prevention of ischemic complications.

Homonymous Hemianopia Secondary to A Long Fusiform Aneurysm of Posterior Cerebral Artery in A Patient with Connective Tissue Disease

Highlight: Fusiform aneurysms are uncommon, accounting for only 1% of total intracranial aneurysms, and posterior circulation involvement is only 3-13% of cases of intracranial aneurysms. Connective tissue diseases are very rare as the cause of this vasculopathy. Homonymous hemianopia due to the mass effect or dilated blood vessels compressing the left optic tract. ABSTRACT Introduction: Fusiform aneurysms are uncommon, accounting for 1% of all intracranial aneurysms. Dissection and atherosclerosis are the main causes of this vasculopathy, but connective tissue disease is a very uncommon cause. Ehlers-Danlos Syndrome is the most common connective tissue disease, accounting for 11% of all cases. Symptoms depend on the location and size of the aneurysm, including headaches, blurred or double vision, and focal neurological deficits. Case: A 36-year-old man suddenly experienced blurred vision in both eyes on the right, starting with a chronic left-sided headache and no history of cardiovascular disease. In the confrontation test, Humphrey gave the right homonymous hemianopia. A head CT scan showed a lobulated lesion which showed enhancement in the left suprasellar region, and cerebral digital subtraction angiography (DSA) gave the impression of a long fusiform aneurysm L PCA. Clinically, the patient’s skin on the left side of his face was darker than on the right, his skin was more elastic, and his blood vessels were wider and more prominent on the side of the fusiform aneurysm. Conclusion: Posterior circulation involvement is only 3-13% of cases of intracranial aneurysms. Many cases of intracranial aneurysms are not detected before rupture, resulting in delays in treatment. Surgical or endovascular surgery can be performed if the size is &gt;10 mm and causes clinical symptoms. Symptoms of ischemia are managed with antiplatelets or anticoagulants. Incidentally detected unruptured aneurysms are generally managed conservatively because of the highly friable nature of the blood vessels in patients with connective tissue diseases.

The Dolenc technique was used to clip 14 cases of ruptured basilar apex aneurysms and posterior cerebral artery aneurysms.

ObjectiveTo investigate the surgical techniques and their clinical effects for ruptured basilar artery apex and posterior cerebral aneurysms via the Dolenc approach.MethodsWe retrospectively analyzed the clinical data of 14 patients with ruptured basilar artery apex and posterior cerebral aneurysms who underwent surgical clipping by the Dolenc approach from July 2017 to June 2020 in Beijing Tiantan Hospital affiliated with Capital Medical University and Lianyungang Hospital affiliated with Xuzhou Medical University. The modified Rankin scale (mRs) scores were used to evaluate the prognosis of patients.ResultsAll 14 cases of aneurysms were successfully clipped. Overall, 1, 2, and 1 cases of postoperative new-onset visual loss, oculomotor nerve palsy, and contralateral hemiplegia, respectively, were reported. Digital subtraction angiography (DSA) or computed tomography angiography (CTA) examination of the aneurysm within 2 weeks after surgery revealed that the aneurysm was completely clipped without residue. The observations during the follow-up within 12–18 months after surgery were as follows: 1 case of vision loss returned to normal, 2 cases of oculomotor nerve palsy, 1 case of return to normal, 1 case of improved, 1 case of contralateral hemiplegia improved after rehabilitation treatment, and 1 case of hydrocephalus ventriculoperitoneal shunt surgery was performed. Overall, 11, 2, and 1 case had mRs scores of 0, 1, and 2, respectively. No death was reported.ConclusionFor the small number of basilar apical and posterior cerebral aneurysms treated non-invasively, the Dolenc approach may offer advantages over other modalities.

Braided stents assisted coiling for endovascular management of posterior cerebral artery aneurysms: a preliminary mid-term experience

Posterior cerebral artery (PCA) aneurysms are rare. This study is to evaluate the preliminary experience of braided stents applied in PCA aneurysms treatment. Angiographic and clinical data of 28 PCA patients treated with braided stents from July 2016 and September 2020 were retrospectively analyzed. A total of 28 PCA aneurysms were enrolled. 22 (78.6%) aneurysms were dissecting aneurysms, while 6 (21.4%) aneurysms were saccular aneurysms. Thirty-five braided stents were implanted with dual stents implanted in 7 cases. Immediate angiographic results show that Raymond class I was obtained in 13 patients (46.4%), Raymond class II was obtained in 4 patients (14.3%), and Raymond class III was obtained in 11 patients (39.3%). Perioperative hemorrhagic events occurred in 1 patient (3.6%). Twenty-four patients (85.7%) received angiographic follow-up, and the mean follow-up time was 11.2 ± 4.9months. Two patients (8.3%) were confirmed with IA neck recurrence, and 3 patients (12.5%) were confirmed asymptomatic parent artery occlusion (PAO). The other 19 patients were confirmed promoted occlusion with 18 Raymond class I (75%) and 1 Raymond class II (4.2%). Twenty-seven patients (96.4%) received clinical follow-up, and the mean follow-up time was 32.2 ± 13.5months. One patient (3.7%) confirmed the death event 2weeks after discharge. The other 27 patients (96.3%) got favorable clinical outcomes with an mRS score of 0-2. Braided stent-assisted coiling with a high occlusion rate and relatively low complication rate provides an alternative strategy in treating PCA aneurysms. Long-term outcomes need further randomized study with larger case numbers.

Multiple different remote epidural hematomas after craniotomy: A case report

BACKGROUNDEpidural hematoma is one of the common postoperative complications after craniotomy. However, multiple remote epidural hematomas in different sites, including supratentorial and infratentorial regions, are exceedingly rare.CASE SUMMARYWe present a rare case in which three remote epidural hematomas occurred after craniotomy. A 21-year-old woman was admitted with a headache for 1 mo, vomiting, and rapid vision loss for 1 wk. Brian magnetic resonance imaging indicated a right thalamic tumor. The intraoperative diagnosis was a cystic tumor, posterior cerebral artery aneurysm, and vascular malformation. The operation was successful. Unfortunately, the patient developed three extradural hematomas within 48 h. Family members consented to the first two hematoma evacuations but refused the third.CONCLUSIONMore attention should be paid to this kind of rare complication. Adequate preoperative evaluation is important, especially for acute patients. Monitoring neural function and early computed tomography scanning of the brain after surgery should be highlighted.

Endoport-assisted microsurgical treatment for a ruptured posterior cerebral artery aneurysm: A technical note.

Posterior Cerebral Artery aneurysms are scarce, yet its territory is frequently associated to large and giant aneurysms. Treatment is mostly a binary option between microsurgical clipping and endovascular coiling. Hybrid approaches are an option too, whereas innovation with less frequent techniques such as endoscope-controlled and endoscope-assisted procedure may provide a safer surgical approach with same successful results. Hereby we report a case of a 53 years old male examined at the ER after presenting generalized seizures and altered state of consciousness. Upon arrival, neurological evaluation revealed homonymous right hemianopia. Computed tomography (CT) scan revealed a subarachnoid hemorrhage and left parieto-occipital intraparenchymal hemorrhage with intraventricular extension; computed tomography angiogram (CTA) revealed an aneurysm at the left posterior cerebral artery (PCA) in its P4 segment. We performed a vascular exploration with drainage of the occipital and intraventricular hematoma through a single endoscopic port through transulcal approach guided by neuronavigation, in addition to clipping and aneurysmectomy. The combination of microsurgical clipping with previous Endoport-guided endoscopic procedure may be a surgical-operative option that not only may facilitate the approach to the desired lesion, but also provides a safer surgical scenario.

Superficial Temporal Artery–Posterior Cerebral Artery Bypass Through Zygomatic Anterior Temporal Approach for Complex Posterior Cerebral Artery Aneurysm

Posterior cerebral artery (PCA) aneurysms are rare, and most are giant, dissecting, or fusiform in morphology. Proximal occlusion of the PCA without revascularization causes high risk of ischemic complications. This study aimed to evaluate the safety and validity of using superficial temporal artery (STA)-PCA bypass through zygomatic anterior temporal approach in complex PCA aneurysms. Trapping or resecting of aneurysms and reconstruction of distal PCA through a zygomatic anterior temporal approach were performed in 6 patients from June 2017 to August 2020. Postoperative angiography confirmed obliteration of aneurysms and patency of bypass artery. Neurological function was assessed by the modified Rankin Scale (mRS). Patients were 4 men and 2 women with a mean age of 43.8 years (range, 21-58 years). Subarachnoid hemorrhage occurred in 5 patients. Hunt and Hess grade was IV in 3 patients, III in 2 patients, and I in 1 patient. All PCA aneurysms were treated with trapping or resection of the aneurysms and revascularization of distal PCA. Postoperatively, all aneurysms were eliminated, and no new permanent neurological deficit was found. During follow-up, mRS score of all patients improved: 2 patients had mRS score 0, 1 patient had mRS score 1, 1 patient had mRS score 3, and 2 patients had mRS score 4. Long-term graft patency rate was 100%. STA-PCA bypass appears to be safe and effective for the treatment of complex PCA aneurysms requiring supplementation of blood flow in the area of the PCA. We established a surgical route, allowing the procedure to be done through the zygomatic anterior temporal approach. This approach provides adequate operative field exposure and reduces retraction of temporal lobe.

Comprehensive Evaluation of a Posterior Cerebral Artery Aneurysm and the Consequences of Rupture on Brain Tissue: The Value of Transcranial Color-Coded Duplex Ultrasonography.

Comprehensive Evaluation of a Posterior Cerebral Artery Aneurysm and the Consequences of Rupture on Brain Tissue: The Value of Transcranial Color-Coded Duplex Ultrasonography.