Abstract
We report a case of an unruptured true posterior inferior cerebellar artery (PICA) aneurysm forming kissing aneurysms with a ruptured vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm in a 49-year-old woman that was successfully treated with direct surgery. Left vertebral angiogram revealed a VA-PICA aneurysm and an adjacent small bulge in the PICA. Intraoperatively, these two aneurysms adhered tightly to one another, necessitating complete dissection and clipping of both aneurysms. This is the first case of kissing aneurysms at the VA-PICA junction to be reported. It is important to remember that we may encounter kissing aneurysms of VA-PICA and PICA. As in the present case, preoperative diagnosis may be difficult.
