====== Posterior inferior cerebellar artery aneurysm ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1vKcRI80qSZ_SfFgi0bDvF8ZA_v4OO0-Zln6ltZI5EUwiIpYFU/?limit=15&utm_campaign=pubmed-2&fc=20230816053215}}
----

----


===== Epidemiology =====

[[Posterior inferior cerebellar artery aneurysm epidemiology]].

===== Classification =====

[[Unruptured Posterior inferior cerebellar artery aneurysm]]

[[Ruptured Posterior inferior cerebellar artery aneurysm]]


^ Segmental Classification of PICA Aneurysms ^
| Segment | Description |
| VA-PICA junction | Most common site (~50%), saccular, SAH risk |
| Anterior medullary | From VA-PICA origin to inferior olivary prominence |
| Lateral medullary | Along lateral medulla to cranial nerves IX–XI |
| Tonsillomedullary | "Caudal loop" around cerebellar tonsil |
| Telovelotonsillar/cortical | Distal cortical branches |

^ Morphological Classification ^
| Type | Description |
| Saccular | Most frequent, bifurcations/curves, SAH risk |
| Fusiform/Dissecting | Traumatic/idiopathic, higher rupture risk |
| Giant | >25 mm, mass effect (cranial nerve, hydrocephalus) |

^ Origin-Based Classification (for Flow Diversion) ^
| Type | Description |
| 1 | PICA originates adjacent/separate to aneurysm neck |
| 2 | PICA originates from aneurysm neck |
| 3 | PICA originates from aneurysm dome |
| 4 | True PICA aneurysm (distal to VA-PICA junction)|



===== Posterior inferior cerebellar artery dissecting aneurysm =====

see also [[Posterior inferior cerebellar artery dissecting aneurysm]].

===== Clinical features =====

The symptoms of a PICA aneurysm may clinically mimic cervical myeloradiculopathy, and that PICA aneurysms may thus be overlooked
((https://www.sciencedirect.com/science/article/pii/S1682606X12000047)).

===== Treatment =====

[[Posterior inferior cerebellar artery aneurysm treatment]].

===== Videos =====


===== Outcome =====
The largest review of PICA aneurysms has been conducted by Peerless and Drake 
((Peerless S J, Drake C G. 4th edition. Philadelphia: W.B. Saunders Co; 1990. Management of aneurysms of the posterior circulation; pp. 806–1764. (, Vol. Vol. 3.).))
who reviewed 146 cases of PICA aneurysms and classified outcomes as excellent, good, poor, and dead, without any objectivity in their outcomes.

These aneurysms have a high re-bleeding rate (78%) and dissecting nature. In the series of Deora et al. too, IVH rates were 80%, while no re-bleeding was encountered. This may be due to the policy to operate within 24 hours of patients’ arrival and early referral of patients 
((Deora H, Nayak N, Dixit P, Vikas V, Rao KVLN, Pruthi N, Srinivas D, Shukla DP, Bhat DI, Malla BR, Devi BI, Somanna S. Surgical Management and Outcomes of Aneurysms of Posterior Inferior Cerebellar Artery: Location-Based Approaches with Review of Literature. J Neurosci Rural Pract. 2020 Jan;11(1):34-43. doi: 10.1055/s-0039-3399486. Epub 2020 Jan 27. PMID: 32269450; PMCID: PMC7138643.)).

These aneurysms present with poor initial neurological status. This is because of the location of this aneurysm. Over 83% of these cases present with [[IVH]] as the blood enters from the [[foramen of Luschka]] or [[foramen of Magendie]] and tracks [[intraventricular]]ly
((Song H H, Won Y D, Kim Y J, Kim B S. The endovascular management of saccular posterior inferior cerebellar artery aneurysms. Korean J Radiol. 2008;9(05):396–400.)).

===== Case series =====

[[Posterior inferior cerebellar artery aneurysm case series]].
===== Case reports =====

[[Posterior inferior cerebellar artery aneurysm case reports]].

===== References =====