scholarly journals Distal posterior inferior cerebellar artery aneurysm: case report

2005 ◽  
Vol 63 (2a) ◽  
pp. 335-338 ◽  
Author(s):  
Ricardo Ramina ◽  
Viviane Aline Buffon ◽  
Jerônimo Buzetti Milano ◽  
Erasmo Barros da Silva Jr ◽  
Kelly Cristina Bordignon
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Computerized Tomography ◽  
Intraventricular Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Subarachnoidal Hemorrhage ◽  
Cerebellar Artery ◽  
Clinical Series ◽  
Pica Aneurysms

The majority of posterior inferior cerebellar artery (PICA) aneurysms are usually found on the bifurcation of the vertebral artery (VA) - PICA junction. Aneurysms arising from more peripheral PICA segments named distal PICA aneurysm are uncommon. The major clinical manifestation is that of an intracranial bleeding and the site of hemorrhage is related to the PICA segment originating the aneurysm. Lesions originating from distal PICA segments, particularly those arising from the telovelotonsillar segment, are associated with hemorrhage extending into the ventricular system, mainly the IV ventricle. A case of a 50-year-old woman with sudden headaches and vomiting, and intraventricular hemorrhage (four ventricles) caused by an aneurysm of the telovelotonsillar segment of the PICA, is presented. No signs of subarachnoidal hemorrhage were found in the computerized tomography. The aneurysm was clipped and the patient presented a favorable outcome. Anatomical aspects and clinical series are reviewed.

scholarly journals Contralateral far-lateral approach for clipping of a ruptured vertebral artery–posterior inferior cerebellar artery aneurysm

2008 ◽  
Vol 25 (6) ◽  
pp. E9 ◽  
Author(s):  
Taryn McFadden Bragg ◽  
Edward A. M. Duckworth
Keyword(s):  
Computed Tomography ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Lateral Approach ◽  
Cerebellar Artery ◽  
Far Lateral Approach ◽  
Far Lateral ◽  
The Right ◽  
Pica Aneurysms

Numerous nuanced approaches have been used to access posterior inferior cerebellar artery (PICA) aneurysms for microsurgical clipping. The authors report the case of a patient with a right vertebral artery (VA)–PICA aneurysm that was reached via a contralateral far-lateral approach. The wide-necked saccular/fusiform aneurysm arose from the lateral aspect of the right V4 segment just proximal to the PICA origin, anterior to the jugular tubercle at the level of the hypoglossal canal. Computed tomography angiograms demonstrated the size and configuration of the aneurysm, and 3D reconstructions revealed the tortuosity of the right VA, defining its location just left of the midline adjacent to the lower clivus. A contralateral far-lateral approach to VA–PICA aneurysms should be considered when aneurysms cross the midline. Computed tomography angiography with volume rendering and interactive software capabilities can help identify the relationship of such an aneurysm to an individual's particular skull base osseous anatomy and is paramount in selecting the optimal microsurgical approach.

Extracranial Posterior Inferior Cerebellar Artery Aneurysm Causing Isolated Intraventricular Hemorrhage: A Case Report

Neurosurgery ◽  
1988 ◽  
Vol 23 (6) ◽  
pp. 774-777 ◽  
Author(s):  
Antonio Ruelle ◽  
Paolo Cavazzani ◽  
Giancarlo Andrioli
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Posterior Inferior Cerebellar Artery ◽  
Artery Aneurysm ◽  
Foramen Magnum ◽  
Computed Tomographic ◽  
Left Posterior ◽  
Cerebellar Artery ◽  
Computed Tomographic Scan ◽  
Pica Aneurysms

Abstract The authors report the unusual case of an aneurysm arising on an extracranial loop of the left posterior inferior cerebellar artery (PICA). The computed tomographic scan showed an isolated hemorrhage in the lateral ventricles, and the lesion was recognized 1.5 cm below the foramen magnum at the level of the atlas. The literature concerning peripheral PICA aneurysms is reviewed and the clinical and radiological features of these lesions are discussed. A tendency for subarachnoid bleeding from distal PICA aneurysm ruptures to spread into the ventricular system is suggested. The diagnosis of distal PICA aneurysm should also be considered in cases of isolated intraventricular hemorrhage without obvious parenchymal or subarachnoid hemorrhage. The need for four-vessel angiography when studying patients suffering from a subarachnoid hemorrhage is stressed.

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