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Updated: Jul 1, 2026
18:50
Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
Published on: September 25, 2009
Distal posterior cerebellar artery aneurysm: case report
V T Jovanović1, M Lj Rakić, B M Djurović
1Institut for Neurosurgery, CCS, Belgrade.
Acta Chirurgica Iugoslavica
|September 17, 2008
Summary
Rare distal posterior inferior cerebellar artery (PICA) aneurysms can cause subarachnoid hemorrhage. Early diagnosis with angio CT is crucial for timely intervention in suspected cases.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Vertebrobasilar aneurysms constitute 15% of intracranial aneurysms, with posterior inferior cerebellar artery (PICA) aneurysms representing 20% of these.
- Distal PICA aneurysms are exceptionally rare, accounting for only 0.5-3% of all aneurysms and less than 1% of posterior circulation aneurysms.
Observation:
- A 70-year-old male presented with sudden headache, neck pain, and vomiting, suggestive of subarachnoid hemorrhage (H&H grade III).
- Initial CT revealed an intracerebellar hematoma and intraventricular blood without hydrocephalus.
- Delayed angio CT identified a distal PICA aneurysm in the telotonsillar segment, confirmed by digital subtraction angiography.
Findings:
- The case highlights a rare distal PICA aneurysm presenting as subarachnoid hemorrhage.
- Surgical intervention was performed three weeks post-hemorrhage, adhering to delayed treatment strategies for posterior circulation aneurysms.
Implications:
- High clinical suspicion for distal PICA aneurysms is warranted, even with their low incidence.
- Angio CT should be considered a primary screening tool for hemorrhages localized in areas consistent with potential aneurysms.
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