Embolization Using N-Butyl Cyanoacrylate for Ruptured Aneurysm of the Posterior Inferior Cerebellar Artery Communicating Artery: A Case Report

Abstract

Objective: We report a case of ruptured aneurysm of the posterior inferior cerebellar artery communicating artery (PICA com A) embolized with n-butyl cyanoacrylate (NBCA).

Case Presentation: A 48-year-old man presented with a sudden headache. Head CT showed acute hemorrhage in the fourth cerebral ventricle. Although initial angiography at admission showed no definitive abnormal findings, repeated angiography on the 20th hospital day revealed a small aneurysm at the PICA com A originating from the telovelotonsillar segment (TTs) of the left PICA. The right PICA was aplastic, and the PICA com A was supplying the right cerebellum. The morphological change in the aneurysm within a short period suggested a high risk of rupture, and therefore, the aneurysm and the PICA com A were embolized together with 33% NBCA on the 23rd hospital day with expecting further development of collaterals to the PICA com A territory from the other cerebellar arteries. Postoperatively, small infarcts were observed in the left cerebellum, but no infarct appeared on the right cerebellum. The patient was discharged on the 33rd hospital day.

Conclusion: We performed embolization with NBCA for the ruptured aneurysm at the PICA com A with a good outcome and no serious complications.