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[True "PICA communicating artery" aneurysm: a case report]
H Udono1, T Shiraishi, T Tsuji
1Department of Neurosurgery, Saga Medical School.
No Shinkei Geka. Neurological Surgery
|August 1, 1997
Summary
This case report details a rare distal posterior inferior cerebellar artery (PICA) aneurysm. Successful surgical clipping was performed on this unusual PICA communicating artery aneurysm.
Area of Science:
- Neurosurgery
- Vascular Neurology
- Cerebrovascular Anatomy
Background:
- Aneurysms of the posterior inferior cerebellar artery (PICA) are uncommon, particularly those arising from distal anastomotic branches.
- Subarachnoid hemorrhage (SAH) necessitates prompt diagnosis and management of the underlying vascular lesion.
Observation:
- A 51-year-old female presented with SAH and altered consciousness, initially showing no vascular anomaly on angiography.
- A distal PICA aneurysm on an anastomotic branch between bilateral PICAs was identified on delayed angiography.
- The patient underwent successful surgical clipping of the aneurysm via suboccipital craniectomy.
Findings:
- This represents the second reported case of a distal PICA communicating artery aneurysm, a rare vascular anomaly.
- The aneurysm was located on an anastomotic vessel between the bilateral distal PICAs.
- Pathogenesis is hypothesized to involve hemodynamic factors and a remnant of a primitive lateral vertebrobasilar anastomosis.
Implications:
- This case highlights the importance of serial angiography in diagnosing elusive cerebrovascular lesions.
- Understanding the embryological origin of such anomalies may provide insights into their development.
- Further research into these rare aneurysms can refine diagnostic and therapeutic strategies.