Abstract
Aneurysms of the distal posterior inferior cerebellar artery (PICA) are relatively rare. The authors have encountered 14 aneurysms in 7 cases of distal PICA aneurysms. We discuss the clinical and radiological features, the problems in surgical and other treatment of this aneurysm, with reference to previous literature. In our 7 cases, 5 were discovered from subarachnoid hemorrhage due to rupture of these aneurysms. Two were nonruptured.
The angiographic appearance of 7 cases were identified; 1 congenital saccular, 2 fusiform, 1 giant thrombosed, 1 is assosiated with persistent primitive hypoglossal artery and in other 2 cases aneurysms located on the feeding artery of arteriovenous malformation (both cases had 4 or more aneurysms)
The locations of 14 distal PICA aneurysms were as follows: 2 on the anterior medullary segment, 1 on the lateral medullary segment, 1 on the tonsilomedullary segment, 5 on the telovelotonsillar segment, and 5 on the cortical segment.
Six cases of 7 were treated surgically, another 1 was a nonsurgical case because of the poor risk on admission. One of the surgical cases on the anterior medullary segment aneurysm was extirpated after OA-PICA anastomosis, which was histologically confirmed as a dissecting aneurysm.
Outcome of our cases, 3 died and the remaining 4 cases have followed excellent postoperative courses.
