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

ABSTRACT

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.