Clinical characteristics and surgical treatment of distal posterior inferior cerebellar artery aneurysms

Abstract

To summarize the clinical characteristics and surgical treatment of distal posterior inferior cerebellar artery (PICA) aneurysms. Ten consecutive cases of distal PICA aneurysms at our institute were retrospectively reviewed from June 2005 to June 2010.Among them, there were 6 males and 4 females with a mean age of 39.1 (26-60) years.The clinical manifestations included intracranial hematoma (n = 9) and mass effect (n = 1). All patients had computed tomography (CT) and digital subtraction angiography (DSA) scans while some of them received computed tomographic angiography (CTA) or magnetic resonance imaging (MRI) examinations. All patients underwent microsurgical suboccipital craniotomy. DSA was the main diagnostic tool. Eight patients had their aneurysms at left side and 2 at right side.The locations were at second section (n = 2), third section (n = 2), forth section (n = 3) and fifth section (n = 3).And 2 cases were associated with arteriovenous malformation at the same side. The diameters of aneurysms were 3-8.3 mm (<5 mm in 5, 5-10 mm in 5). The outcomes included clipping (n = 6), trapping (n = 3) and resection plus vessel anastomosis (n = 1). In all cases, treatment was successful without neurological deficits.One patient had postoperative complication of intracranial infection and 1 patient with hydrocephalus underwent ventricular-peritoneal shunt.All of them achieved excellent recovery. The mean follow-up period was 4.6 years (range:2-5). None of them suffered re-bleeding.And the mean modified Rankin scale scores was 4.9. Patients with distal PICA aneurysms may obtain excellent outcome after microsurgery.