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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Posterior Meningeal Artery Origin Patterns among 300 Cases and Their Clinical Importance

Tomotaka Ohshima1, Takashi Handa2, Kojiro Ishikawa3

  • 1Neuroendovascular Center, Department of Neurosurgery, Aichi Medical University, Nagakute, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|March 31, 2018
PubMed
Abstract

Insights

Transarterial embolization of the posterior meningeal artery (PMA) can lead to Wallenberg syndrome. Careful consideration of brainstem nourishment is crucial, especially when the PMA originates from the intracranial vertebral artery.

Area of Science:

  • Vascular neurosurgery
  • Neurointerventional radiology

Background:

  • The posterior meningeal artery (PMA) typically supplies the dura mater.
  • Dural arteriovenous fistulas (DAVFs) are abnormal vascular connections often treated via embolization.

Observation:

  • A patient undergoing transarterial embolization of a PMA associated with a transverse-sigmoid sinus DAVF developed Wallenberg syndrome.
  • Symptoms included vertigo and right-sided extremity numbness, confirmed by MRI showing medullary hyperintensity.

Findings:

  • The patient's PMA originated directly from the intracranial vertebral artery.
  • This anatomical variation may predispose to compromised brainstem perfusion during embolization.

Implications:

  • Embolization of PMAs, particularly those arising from the vertebral artery, requires careful assessment for potential brainstem hypoperfusion.
  • Awareness of this risk is vital for preventing neurological deficits like Wallenberg syndrome in neurointerventional procedures.
Keywords:
Dural arteriovenous fistulaWallenberg syndromeendovascular treatmentposterior meningeal artery

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