Abstract
The distal aneurysms of posterior inferior cerebellar artery (PICA) are relatively uncommon, accounting for less than 0.5-3.0% of all aneurysms.
We clinically analyzed 63 cases of the distal aneurysm of PICA-7 cases we treated over the last 5 years at our institute and 56 cases reported in the literature. The most common CT findinges of these cases in subarachnoid hemorrhage with intraventricular hemorrhage in 27 cases (43%), complication of hydrocephalus in 21 cases (33.3%), vasospasm in 12 cases (19.0%), and arteriovenous malformation in 5 cases (7.9%). Fifty-four cases were surgically treated, and 9 cases were conservatively treated. In surgical treatment, direct neck clipping of the aneurysm was carried out in 38 cases, coating of the aneurysm in 6 cases, trapping in 3 cases, proximal ligation in 3 cases, wrapping in 2 cases, excision and end-to-end anastomosis in 2 cases. The outcome of these surgically treated cases shows good recovery in 43 cases, moderately disablities in 5 cases, and death in 6 cases. Based on these reports, surgical treatment is recommended. The characteristic CT finding of distal PICA aneurysm is intraventricular hemorrhage and there was no significant difference in the site of aneurysm. Vascular malformation is commonly seen with this aneurysm.
