Posterior inferior cerebellar artery aneurysm case reports

Aronov et al. from the Endovascular Division, Department of Neurosurgery, Neuro ICU, State Research Center Burnasyan FMBC of the FMBA of Russia Moscow, Department of Neurosurgery University of South Florida, report two patients presenting with SAH secondary to small (3 and 4 mm) dissecting fusiform aneurysms located within 1 cm distally to PICA origin, treated with a novel endovascular approach.

Two patients presented with SAH secondary to a very small ruptured fusiform aneurysm of the proximal section of PICA trunk. Both patients were treated by coil embolization combined with parent artery preservation by microcatheter auto-assistance. Both coiling procedures were uneventful, and the patients remained asymptomatic. Long-term follow-up angiography in both patients showed complete occlusion of the aneurysms with patency of the PICA ¹⁾.

Ideguchi M, Nishizaki T, Ikeda N, Nakano S, Okamura T, Tanaka Y, Fujii N, Ohno M, Shimabukuro T. [Usefulness of Thin-Slab Maximum Intensity Projections in Imaging of the Multiple Aneurysms that Arise at the Distal Portion of the Posterior Inferior Cerebellar Artery]. No Shinkei Geka. 2017 Nov;45(11):1003-1009. doi: 10.11477/mf.1436203636. Japanese. PubMed PMID: 29172207.

A patient who presented with cervical myeloradiculopathy (manifested by neck, shoulder, and arm pain) and an unsteady gait whose symptoms persisted after surgery on the cervical spine. A PICA aneurysm was diagnosed incidentally when we performed computed tomography (CT) of the brain and angiography after he fell into a coma. The patient was successfully treated with endovascular therapy. The symptoms of a PICA aneurysm may clinically mimic cervical myeloradiculopathy, and that PICA aneurysms may thus be overlooked ²⁾.