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. 2020 Aug 3;88(1):82–95. doi: 10.1093/neuros/nyaa317

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© Congress of Neurological Surgeons 2020.

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

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FIGURE 8. — Imaging studies of another case of staged remote proximal parent artery occlusion (RPO) and high-flow radial artery graft bypass from the extracranial VA to the posterior cerebral artery (PCA) (see Video, Supplemental Digital Content, second case). A 52-yr-old woman presented with subarachnoid hemorrhage (SAH) caused by rupture of a giant fusiform and dolichoectatic aneurysm of the basilar trunk (BT-GFDA). A, MR image taken 5 mo prior demonstrated a mid-basilar partially thrombosed giant fusiform aneurysm with small intramural hemorrhage. B, Computed tomography (CT) at admission demonstrated SAH with hematoma in the fourth ventricle. C, Cerebral angiogram showed a mid-basilar, partially thrombosed giant dolichoectatic aneurysm. D, Postoperative angiogram showed disappearance of the BT-GFDA and patent extracranial VA to PCA bypass. E, Postoperative T2-weighted MR image showed complete thrombosis of the aneurysm with slight pontine ischemia. F, Follow-up MR image 1 yr after the treatment revealed successful aneurysm thrombosis and shrinkage. She recovered well and no rebleeding occurred during the 180-mo follow-up period.