"True" posterior communicating aneurysms: Three cases, three strategies

Area of Science:

• Neurosurgery
• Vascular Neurology
• Interventional Radiology

Background:

• True aneurysms of the posterior communicating artery (PCoA) are uncommon cerebrovascular lesions.
• A review of PCoA aneurysms is presented, with three distinct cases discussed.

Purpose of the Study:

• To review the characteristics and management of true posterior communicating artery aneurysms.
• To present and analyze three clinical cases of ruptured PCoA aneurysms.

Main Methods:

• Case 1: 51-year-old female with subarachnoid hemorrhage (SAH) treated with pterional craniotomy and aneurysm clipping.
• Case 2: 53-year-old female with SAH and multiple aneurysms, including a PCoA aneurysm, treated with pterional craniotomy.
• Case 3: 69-year-old male with SAH and subclavian artery occlusion, treated with endovascular angioplasty and stenting.

Main Results:

• All three patients with true PCoA aneurysms achieved successful treatment outcomes.
• The first patient recovered without neurological deficit post-surgery.
• The second patient experienced complete muscle strength recovery, and the third patient achieved aneurysm occlusion via endovascular intervention.

Conclusions:

• True PCoA aneurysms, though rare, can be effectively managed using diverse therapeutic approaches.
• Successful treatment can be achieved through both open surgical and endovascular techniques.