Aneurysms of Distal Posterior Inferior Cerebellar Artery

OBJECTIVE: Aneurysms are very rarely encountered in the distal posterior inferior cerebellar artery (PICA). The authors experienced 5 cases with a distal PICA aneurysm among 368 cases of intracranial aneurysms during the period from January 2003 to January 2008. Here, the authors describe their clinical and surgical experiences and include a review of the relevant literature. METHODS: Using radiologic findings and charts, we retrospectively reviewed the surgical results of 5 cases with a distal PICA aneurysm treated from January 2003 to January 2008. RESULTS: The current five cases were composed of four cases of 'Good' and one case of 'Fair'. No postoperative complications occurred other than a ventriculo-peritoneal shunt due to hydrocephalus in Case 2. In all five cases, treatment was successful without neurological deficit. CONCLUSION: Surgical outcome of PICA aneurysms have been reported to be excellent because the amount of intraparenchymal injury is limited. More clinical experience, microsurgical technique developments, and endovascular surgery advancements are certain to improve treatment outcomes.

Ruptured Aneurysm of Distal Posterior Inferior Cerebellar Artery: Report of Two Cases / 대한뇌혈관외과학회지

Aneurysms arising from the distal posterior inferior cerebellar artery (PICA) are rare. We present two cases of ruptured distal PICA aneurysms. A 48-year-old woman was admitted to our hospital because of sudden onset of severe headache and vomiting. A radiological examination revealed intraventricular hemorrhage (IVH) caused by rupture of a right distal PICA aneurysm. The aneurysm was clipped completely through a midline suboccipital approach. A 74-year-old woman was admitted to our hospital because of sudden onset of severe headache and vomiting, which was followed by unconsciousness. A radiological examination showed a hematoma in the cerebellar vermis and IVH from the fourth ventricle to the lateral ventricle with severe hydrocephalus caused by rupture of a left distal PICA aneurysm. After emergency extraventricular drainage was performed, the aneurysm was obliterated by the use of proximal parent artery clipping and coagulation. Aneurysms of the distal PICA are frequently associated with structural vascular anomalies and a high incidence of bleeding when these aneurysms are small. Thus, distal PICA aneurysms should be obliterated in almost all instances whenever they are encountered and these aneurysms should be managed immediately because of the high risk of rebleeding.