PMC8492441_01
A computed tomography image shows the subdural hematoma (dotted line) within the posterior fossa and cervical spine.
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F1
On exam, he was intubated, with a Glasgow coma scale of 9, and imaging of the head and neck revealed a subdural hematoma of the posterior fossa and the cervical spine [Figure 1].
(a) A 3D reconstruction of the left occipital artery angiogram that shows the aneurysm. (b) A subtracted angiographic image of the left occipital artery that shows the occipital artery and the aneurysm.
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F2
Postoperative cerebral angiography showed an intracranial aneurysm arising from the retro-mastoid branch of the OA on the left side [Figure 2].
(a) A subtracted angiographic image (pre-embolization) of the left occipital artery (capillary phase) that shows the cerebellar blood supply. (b) A subtracted angiographic image (post-embolization) of the left occipital artery (capillary phase) that shows the diminished cerebellar blood supply.
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F3
Balloon test occlusion of the OA showed some cross filling of the left lower cerebellar hemisphere through the left posterior inferior cerebellar artery (PICA) [Figures 3 and 4].
(a) A subtracted angiographic image (pre-embolization) of the left posterior inferior cerebellar artery (late-arterial phase) that shows the cerebellar blood supply. (b) A subtracted angiographic image (post-embolization) of the left occipital artery (late-arterial phase) that shows the increased cerebellar blood supply.
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F4
Balloon test occlusion of the OA showed some cross filling of the left lower cerebellar hemisphere through the left posterior inferior cerebellar artery (PICA) [Figures 3 and 4].
MRI image (diffusion-weighted sequence, axial view) that shows the minor stroke of the left cerebellar hemisphere after embolizing the occipital artery aneurysm along with the parent vessel.
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F5
The patient tolerated the procedure well, and magnetic resonance imaging of the brain showed a minor left-sided cerebellar infarct, which was asymptomatic [Figure 5].