Basilar artery perforator aneurysm
Updates to Case Attributes
Basilar artery perforator aneurysms (BAPA) are a rare entity of intracranial aneurysms. While in many cases of perimesencephalic subarachnoid haemorrhage no cause is found, BAPA are a possible cause and are easily overseen even with extensive diagnostic workup including CT, MRI, MRA and DSA. They are another reason why in apparently angio-negative SAH a second DSA and performing 3D angiograms are recommended.
Endovascular treatment options are available including Coil occlusion or flow diverter stent implantation. Some cases in the literature have been treated surgically, however there are technical difficulties (small neck, proximity of BA perforators or branches). The natural cause of BAPA seems rather benign and conservative treatment often is the only option anyways.
Case imaging courtesy of Prof. R. Chapot (Alfried Krupp Krankenhaus Essen, Germany).
-<p>Basilar artery perforator aneurysms (BAPA) are a rare entity of intracranial aneurysms. While in many cases of perimesencephalic subarachnoid haemorrhage no cause is found, BAPA are a possible cause and are easily overseen even with extensive diagnostic workup including CT, MRI, MRA and DSA. They are another reason why in apparently angio-negative SAH a second DSA and performing 3D angiograms are recommended.</p><p>Endovascular treatment options are available including Coil occlusion or flow diverter stent implantation. Some cases in the literature have been treated surgically, however there are technical difficulties (small neck, proximity of BA perforators or branches). The natural cause of BAPA seems rather benign and conservative treatment often is the only option anyways. </p>- +<p>Basilar artery perforator aneurysms (BAPA) are a rare entity of intracranial aneurysms. While in many cases of perimesencephalic subarachnoid haemorrhage no cause is found, BAPA are a possible cause and are easily overseen even with extensive diagnostic workup including CT, MRI, MRA and DSA. They are another reason why in apparently angio-negative SAH a second DSA and performing 3D angiograms are recommended.</p><p>Endovascular treatment options are available including Coil occlusion or flow diverter stent implantation. Some cases in the literature have been treated surgically, however there are technical difficulties (small neck, proximity of BA perforators or branches). The natural cause of BAPA seems rather benign and conservative treatment often is the only option anyways. </p><p>Case imaging courtesy of Prof. R. Chapot (Alfried Krupp Krankenhaus Essen, Germany).</p>