{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:23:12Z","timestamp":1770351792437,"version":"3.49.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"15","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Cerebral aneurysms of perforating arteries are rare and can be difficult to detect on computed tomography angiography (CTA) and digital subtraction angiography. Treatment is challenging and associated with a significant risk of morbidity. Endovascular treatment of a thalamoperforating artery (TPA) aneurysm within the midbrain has not previously been reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 13-year-old girl with no previous medical history presented with unconsciousness and anisocoria. Head computed tomography showed a right midbrain hemorrhage. CTA showed a midbrain arteriovenous malformation fed by a TPA aneurysm arising from the P1 segment of the right posterior cerebral artery. The feeder had a small distal aneurysm, which increased in size over time. Endovascular embolization was then performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Cerebral aneurysms of perforating arteries are rare and can be difficult to treat. This is the first report of the endovascular treatment of a TPA aneurysm within the midbrain. Understanding the individual patient\u2019s brainstem perforator anatomy and the associated blood flow is essential before occluding a TPA aneurysm to avoid causing ischemia or infarction. Arteriovenous malformation embolization within the brainstem should be avoided because of interperforator anastomoses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23294","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T20:28:49Z","timestamp":1696883329000},"source":"Crossref","is-referenced-by-count":3,"title":["Ruptured brainstem arteriovenous malformation associated with a thalamoperforating artery aneurysm arising from the P1 segment of the right posterior cerebral artery: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Yoshihito","family":"Hirata","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Okawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Abekura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisae","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Yamao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Arakawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Faculty of Medicine, Kyoto University, Kyoto, Japan; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"J Neurointerv Surg","first-page":"546","article-title":"Perforator aneurysms of the posterior circulation: case series and review of the literature","volume":"5","author":"Ding D","year":"2013","unstructured":"Ding D, Starke RM, Jensen ME, Evans AJ, Kassell NF, Liu KC. Perforator aneurysms of the posterior circulation: case series and review of the literature. J Neurointerv Surg. 2013;5(6):546\u2013551."},{"issue":"5","key":"b2","series-title":"J Neurosurg","first-page":"1107","article-title":"Spontaneous resolution of perforator aneurysms of the posterior circulation","volume":"121","author":"Chavent A","year":"2014","unstructured":"Chavent A, Lefevre PH, Thouant P,  Spontaneous resolution of perforator aneurysms of the posterior circulation. J Neurosurg. 2014;121(5):1107\u20131111."},{"issue":"3","key":"b3","series-title":"Int J Med Sci","first-page":"234","article-title":"Treatment strategies for aneurysms associated with moyamoya disease","volume":"12","author":"Zhang L","year":"2015","unstructured":"Zhang L, Xu K, Zhang Y, Wang X, Yu J. Treatment strategies for aneurysms associated with moyamoya disease. 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World Neurosurg. 2020;138:218\u2013222."},{"issue":"1","key":"b9","series-title":"J Clin Neurosci","first-page":"80","article-title":"The perforating branches of the P1 segment of the posterior cerebral artery","volume":"17","author":"Kaya AH","year":"2010","unstructured":"Kaya AH, Dagcinar A, Ulu MO,  The perforating branches of the P1 segment of the posterior cerebral artery. J Clin Neurosci. 2010;17(1):80\u201384."},{"issue":"3","key":"b10","series-title":"J Neurosurg","first-page":"752","article-title":"Microsurgical anatomy of the central core of the brain","volume":"129","author":"Ribas EC","year":"2018","unstructured":"Ribas EC, Ya\u011fmurlu K, de Oliveira E, Ribas GC, Rhoton A. Microsurgical anatomy of the central core of the brain. J Neurosurg. 2018;129(3):752\u2013769."},{"issue":"3","key":"b11","series-title":"Gegenbaurs Morphol Jahrb","first-page":"364","article-title":"The central branches of the anterior and median cerebral artery","volume":"124","author":"Lang J","year":"1978","unstructured":"Lang J, Brunner FX. The central branches of the anterior and median cerebral artery. Article in German. Gegenbaurs Morphol Jahrb. 1978;124(3):364\u2013374."},{"issue":"2","key":"b12","series-title":"J Clin Neurosci","first-page":"134","article-title":"Variations in the origin of the thalamoperforating arteries","volume":"14","author":"Uz A","year":"2007","unstructured":"Uz A. Variations in the origin of the thalamoperforating arteries. J Clin Neurosci. 2007;14(2):134\u2013137."},{"issue":"1","key":"b13","series-title":"J Korean Neurosurg Soc","first-page":"36","article-title":"Morphological characteristics of the thalamoperforating arteries","volume":"47","author":"Park SQ","year":"2010","unstructured":"Park SQ, Bae HG, Yoon SM, Shim JJ, Yun IG, Choi SK. Morphological characteristics of the thalamoperforating arteries. J Korean Neurosurg Soc. 2010;47(1):36\u201341."},{"issue":"3","key":"b14","series-title":"Acta Neurochir (Wien)","first-page":"533","article-title":"The artery of Percheron revisited: a cadaveric anatomical study","volume":"155","author":"Kocaeli H","year":"2013","unstructured":"Kocaeli H, Yilmazlar S, Kuytu T, Korfali E. The artery of Percheron revisited: a cadaveric anatomical study. 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