Abstract
Double origin of the posterior inferior cerebellar artery (DOPICA) is a rare anatomical variant that is frequently associated with aneurysms. In this report, we describe a case of coil embolization of a ruptured aneurysm of the posterior inferior cerebellar artery (PICA), and despite occlusion of the entire PICA during the procedure, the patient survived ischemia due to collateral blood flow from another origin of the PICA. A 35-year-old man with dizziness, nausea, and headache presented with subarachnoid hemorrhage on head computed tomography (CT). Digital subtraction angiography (DSA) showed side-wall-type aneurysm in the right PICA and coil embolization was performed. The parent artery was spared and only the aneurysm was embolized successfully. The patient had no postoperative complications or symptoms. Seven days after the surgery, MRI showed no new cerebral infarction, but a magnetic resonance angiogram (MRA) showed occlusion at the origin of the PICA and the aneurysm. DSA showed that a second origin of the PICA functioned as collateral circulation to supplement the perfusion of the distal PICA. In PICA aneurysms in patients with DOPICA, a second PICA origin may serve collateral circulation after coil embolization.
