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Bilateral (mirror-image) aneurysms at the origin of the posteroinferior cerebellar artery: case report
1Department of Surgery, University of Iowa College of Medicine, Iowa City 52242, USA.
Objective And Importance:
This case demonstrates mirror-image aneurysms at the origin of the posteroinferior cerebellar arteries. To the best of our knowledge, this location has not been previously described. Identification of this entity is important for surgical planning.
Clinical Presentation:
The patient presented with a history of a sentinel headache 1 week before his Grade I subarachnoid hemorrhage occurred. Before operative intervention, the patient developed acute deterioration of his mental status from hydrocephalus. After appropriate treatment for the hydrocephalus, he maintained a stable neurological course throughout evaluation and therapy.
Intervention:
The patient underwent bilateral clipping of his aneurysms in a prone position without consequence.
Conclusion:
This case demonstrates a highly unusual mirror-image aneurysm of the proximal posteroinferior cerebellar arteries. Although multiple aneurysms are commonplace, to the best of our knowledge, this is the first reported case of bilateral posteroinferior cerebellar artery aneurysms at their origin. Also, the surgical approach is unique and allows bilateral clipping at the same operative setting.