Management of Distal Posterior Inferior Cerebellar Artery Aneurysms

Abstract

Most of the posterior inferior cerebellar artery (PICA) aneurysms arise at the vertebral artery-PICA junction; distal PICA aneurysms are rare. Their clinical features and treatments are not fully understood. This was a retrospective study. We reported 9 patients with the distal PICA aneurysms treated by surgical clipping or endovascular embolization in our neurosurgical center. All patients experienced sudden onset of headache with subarachnoid hemorrhage. The location of PICA aneurysms was at the anterior-medullary (n = 4), tonsillomedullary (TM) (n = 1), and telovelotonsillar (n = 4). Surgical clipping was performed in 3 and endovascular coil in 6 patients. All the PICA aneurysms were occluded with parent artery preservation, and all of the patients achieved good recovery. Distal PICA aneurysm is exceptionally rare; it could be treated successfully with surgical clipping or endovascular treatments.