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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(02): 322-329
DOI: 10.1055/s-0045-1804999
Original Article

Ruptured Basilar Artery Perforator Aneurysm: Nightmare of a Treating Neurosurgeon

Pragyan Sarma 
1   Department of Neurosurgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Atul Agrawal 
1   Department of Neurosurgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
,
Amit Kumar Sharma 
1   Department of Neurosurgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Abstract

Objectives Subarachnoid hemorrhage (SAH) resulting from rupture of basilar artery perforator aneurysm (BAPA) is a neurological rarity. With increased awareness and advancements in imaging modalities, they are now more frequently detected. However, concerns regarding their suboptimal treatment and lack of proper analysis still exist. We are hereby reporting our experience of treating this entity in a small cohort.

Materials and Methods It is a retrospective study of all the cases of SAH resulting from rupture of BAPA, which were treated by the same surgical team. Demographic data, treatment characteristics, and follow-up data of our cases along with published literature were studied.

Results Our cohort comprised of five patients (mean age 55 years). Three cases were treated with flow diverter alone and the rest underwent flow diverter and overlapping stent placement. Initial diagnostic cerebral angiography (digital subtraction angiography) was negative in three of them. There was one mortality and favorable outcome was encountered in the remaining cases. All of them demonstrated complete occlusion of the aneurysm in follow-up.

Conclusion Following treatment, all the cases demonstrated complete angiographic occlusion of the aneurysm. In available literature, studies have small sample sizes. Future randomized studies in a larger cohort and proper reporting and analysis of outcomes will help us formulating a treatment protocol for BAPA.

Keywords

BAPA - DSA - FD - SAH - DAPT

Authors' Contributions

P.S. contributed to the concept, design, data collection and analysis, review of literature, and manuscript writing. A.A. was involved in manuscript writing and data collection, while A.K.S. also contributed to manuscript writing and data collection.




Publikationsverlauf

Artikel online veröffentlicht:
06. März 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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