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Fenestration of the posteroinferior cerebellar artery: case report
P V Theodosopoulos1, M T Lawton
1Department of Neurological Surgery, School of Medicine, University of California San Francisco, USA.
Objective And Importance:
Fenestrations of cerebral arteries are rare, but very important to diagnose given their high association with saccular aneurysms. We present the first reported case of a fenestration of the posteroinferior cerebellar artery (PICA).
Clinical Presentation:
A 62-year-old man who presented with a subarachnoid hemorrhage underwent repeated four-vessel cerebral angiography. An isolated right PICA abnormality consistent with a dissection or fenestration was revealed.
Intervention:
The patient underwent surgical exploration of his PICA, which confirmed a PICA fenestration without an associated saccular aneurysm. The fenestration was wrapped with cotton.
Conclusion:
Our case report illustrates the novel anatomic finding of a fenestration of the PICA. Knowledge of this entity would be helpful in the differential diagnosis of a posterior fossa subarachnoid hemorrhage.