Extracranial distal aneurysm of posterior inferior cerebellar artery

Abstract

An unusual aneurysm arising from an extracranial lateral medullary segment of the posterior inferior cerebellar artery (PICA) is reported. The origin of the PICA was also extracranial, 10 mm below the foramen magnum. The aneurysm was not seen on three-vessel angiography. The literature is reviewed with regard to the clinical and radiological features of such aneurysms. Occipital and nuchal headache with an altered level of consciousness, intraventricular haemorrhage, and hydrocephalus are suggestive of such aneurysm. The need for four-vessel angiography is again stressed.

Subarachnoid Hemorrhage Caused by Ruptured Dissecting Aneurysm Arising From the Extracranial Distal Posterior Inferior Cerebellar Artery -Case Report-

“…[1][2][3][4][5][6][7][8][9][11][12][13]15,16) Most aneurysms were saccular. Surgical interventions including endovascular procedures were performed in all cases, but clipping was employed in most cases.…”

Aneurysm of the Distal Posterior Inferior Cerebellar Artery Originating from the Extracranial and Extradural Vertebral Artery-Case Report-

“…6) Only five previous cases of distal PICA aneurysms with an extracranial and extradural PICA origin have been reported. 1,3,7,10,11) Therefore, the present case is the sixth such case.…”

“…8) Aneurysms of the PICA are relatively rare, accounting for only 0.5% to 3% of all intracranial aneurysms. 3) PICA aneurysm usually arises from the junction of the VA and the PICA, and rarely from the distal portion of the PICA, in only 15% to 30% of all PICA aneurysms. 6) Only five previous cases of distal PICA aneurysms with an extracranial and extradural PICA origin have been reported.…”

21 Endovascular Treatment of Posterior Circulation Aneurysms

“…All patients (10/10 patients, 100%) with a nonruptured aneurysm and eight patients (11/13 patients, 85%) with a ruptured aneurysm presenting with SAH had good recovery or moderate disability (GOS I and II) upon final assessment. (Chen and Chen 1997;Andoh et al 2001). …”