Progressive enlargement of a previously coiled posterior inferior cerebellar artery aneurysm

Abstract

Multidisciplinary treatment of cerebral aneurysms includes endovascular coiling and open neurosurgical clipping techniques, however our understanding of long-term outcomes after coiling of large cerebral aneurysms remains limited. We present a case involving the development of a previously coiled posterior inferior cerebellar artery (PICA) aneurysm in a 64-year-old man with lesion enlargement and symptomatic mass effect. CT angiogram demonstrated a 3.9×2.6×2.4-cm partially thrombosed aneurysm adjacent to the left vertebral artery. The patient underwent resection to relieve the compressive effect. We discuss the efficacy of endovascular coiling and surgical clipping in this case as well as review the relevant literature.