{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:01:53Z","timestamp":1788883313636,"version":"build-2803163510"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Two distinct categories of aneurysms are described in relation to the posterior inferior cerebellar artery (PICA) and vertebral artery (VA): saccular (SA) and dissecting (DA) types. This distinction is often unrecognized because abnormalities here are uncommon and most studies are small.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine if there are any differences in the clinical presentation, in-hospital course, or outcomes in patients with DA vs SA of the PICA or VA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Thirty-eight patients with a VA or PICA aneurysm were identified from a departmental subarachnoid hemorrhage database and categorized into DA or SA types. Prospectively collected demographic and outcome data (length of stay, discharge Glasgow Outcome Score) were supplemented by abstracting records for procedural data (extraventricular drain [EVD], ventriculoperitoneal [VP] shunt, tracheostomy, and nasogastric feeding). Univariate, binary logistic regression, and Cox regression analysis was used to compare patients with SA vs DA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Three aneurysms related to arteriovenous malformation were excluded. Five patients were conservatively managed. Of the 30 treated cases, more patients with a DA presented in poor grade (6\/13 vs 2\/17 SA;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .035). More DA patients required an EVD (85% vs 29%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003), VP shunt (54% vs 6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003), tracheostomy (46% vs 6%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01), and nasogastric feeding (85% vs 35%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .007). The median length of stay (41 vs 17 d,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) was longer, and the age and injury severity adjusted odds of discharge home were significantly lower in the DA group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .008). Thirty-day mortality was not significantly different (23% of DA vs 24% of SA;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>The presentation, clinical course, and outcomes differ in patients with DA vs SA of the PICA and VA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyx155","type":"journal-article","created":{"date-parts":[[2017,3,11]],"date-time":"2017-03-11T23:14:55Z","timestamp":1489274095000},"page":"93-98","source":"Crossref","is-referenced-by-count":11,"title":["Posterior Inferior Cerebellar Artery\/Vertebral Artery Subarachnoid Hemorrhage: A Comparison of Saccular vs Dissecting Aneurysms"],"prefix":"10.1227","volume":"82","author":[{"given":"Mitchell T","family":"Foster","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Salford Royal NHS Foundation Trust, Stott Lane, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Herwadkar","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Salford Royal NHS Foundation Trust, Stott Lane, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiren C","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Salford Royal NHS Foundation Trust, Stott Lane, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,1]]},"reference":[{"issue":"2","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"391","DOI":"10.3171\/2013.10.JNS13419","article-title":"The relationship between ruptured aneurysm location, subarachnoid hemorrhage clot thickness, and incidence of radiographic or symptomatic vasospasm in patients enrolled in a prospective randomized controlled trial","volume":"120","author":"Abla","year":"2014","journal-title":"J Neurosurg"},{"issue":"2","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3171\/jns.1966.25.2.0219","article-title":"SECTION V, PART I: natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations","volume":"25","author":"Locksley","year":"1966","journal-title":"J Neurosurg"},{"issue":"3","key":"bib3-20231011","first-page":"527","article-title":"Endovascular treatment of isolated dissecting aneurysm of the posterior inferior cerebellar artery","volume":"27","author":"Maimon","year":"2006","journal-title":"AJNR Am J Neuroradiol"},{"issue":"5","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"712","DOI":"10.3171\/jns.2001.94.5.0712","article-title":"Pathological mechanism and three-dimensional structure of cerebral dissecting aneurysms","volume":"94","author":"Mizutani","year":"2001","journal-title":"J Neurosurg"},{"issue":"1","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"25","DOI":"10.3171\/jns.2004.101.1.0025","article-title":"Intracranial vertebral artery dissection with subarachnoid hemorrhage: clinical characteristics and outcomes in conservatively treated patients","volume":"101","author":"Yamada","year":"2004","journal-title":"J Neurosurg"},{"issue":"2","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"98","DOI":"10.2176\/nmc.oa.2013-0184","article-title":"Endovascular treatment for ruptured vertebral artery dissecting aneurysms: results from Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2","volume":"54","author":"Satow","year":"2014","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"1","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"44","DOI":"10.3171\/2008.5.17560","article-title":"Prediction of ventriculoperitoneal shunt dependency in patients with aneurysmal subarachnoid hemorrhage","volume":"110","author":"Chan","year":"2009","journal-title":"J Neurosurg"},{"issue":"1","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1136\/jnnp.2005.063107","article-title":"Arterial hypertension as risk factor for spontaneous cervical artery dissection. A case-control study","volume":"77","author":"Pezzini","year":"2006","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"3","key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"644","DOI":"10.3171\/2014.10.JNS132694","article-title":"Prognostic value of premorbid hypertension and neurological status in aneurysmal subarachnoid hemorrhage: pooled analyses of individual patient data in the SAHIT repository","volume":"122","author":"Jaja","year":"2015","journal-title":"J Neurosurg"},{"issue":"4","key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/0002-9343(75)90260-0","article-title":"The hypertensive diseases. Evidence that systemic hypertension is a greater risk factor to the development of other cardiovascular diseases than previously suspected","volume":"59","author":"Roberts","year":"1975","journal-title":"Am J Med"},{"issue":"2","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1179\/016164102101199666","article-title":"Vertebrobasilar dissection: a possible role of whiplash injury in its pathogenesis","volume":"24","author":"Chung","year":"2002","journal-title":"Neurol Res"},{"key":"bib15-20231011","first-page":"1","article-title":"Clinical characteristics and long-term outcomes in patients with ruptured posterior inferior cerebellar artery aneurysms: a comparative analysis","author":"Williamson","year":"2015","journal-title":"J Neurosurg"},{"issue":"5","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1227\/NEU.0000000000000677","article-title":"Long-term functional outcomes and predictors of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms in the BRAT trial: revisiting the clip vs coil debate","volume":"76","author":"Zaidi","year":"2015","journal-title":"Neurosurgery"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/article-pdf\/82\/1\/93\/32601530\/nyx155.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/00006123-201801000-00016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:36Z","timestamp":1786121376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201801000-00016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,10]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyx155","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,10]]}}}