Giant posterior inferior cerebellar artery aneurysm with dysphagia

Presented is a case of giant aneurysm of the posterior inferior cerebellar artery with the unusual clinical presentation of dysphagia to the point of inability to swallow even oral secretions, resulting in severe malnutrition. A computed tomography scan with contrast-medium enhancement appeared normal. The correct diagnosis was suspected from the results of metrizamide myelocisternography and was confirmed at angiography. The patient underwent ligation of the feeding right vertebral artery with subsequent improvement in her dysphagia and resolution of her other neurological deficits. Discussion of the incidence, diagnosis, and treatment of this uncommon lesion is presented.