The incidence of posterior inferior cerebellar artery (PICA) aneurysms is estimated to be between 0.5% and 3% of total aneurysm cases.1 Most patients with these aneurysms typically present with subarachnoid hemorrhage, although there are instances in which patients may present with symptoms resulting from mass effect exerted on the brain stem or lower cranial nerves.1,2 Treatment options for PICA aneurysms include endovascular procedures, surgical clipping, or bypass techniques.2 Surgical treatment is considered more effective for partially thrombosed aneurysms compared with endovascular approaches.3 In addition, endovascular coiling of these aneurysms carries the potential risk of coil migration and subsequent reopening of the aneurysm lumen.4 In certain instances, thrombosed PICA aneurysms have the potential to simulate the radiological characteristics of alternative pathologies, such as cavernous malformations or brainstem tumors.5-7 This situation can result in misdiagnosis and inappropriate management. We present the case of a patient who exhibited symptoms of imbalance and dysfunction in the lower cranial nerves. Magnetic resonance imaging findings indicated a possible cavernous malformation in the medulla oblongata. However, further investigation revealed that the underlying cause was a thrombosed PICA aneurysm. The patient was successfully treated through surgical clipping. The patient consented to the procedure and to the publication of his/her image.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1227/ons.0000000000001077 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Analysis of the efficacy and factors affecting the prognosis of intracranial dissecting aneurysm treated with multi-stent overlap technique.
BMC Neurol
December 2024
Department of Neurological Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, 183 Yiling Avenue, Yichang City, Wujiagang District, China.
Objective: The study aims to identify characteristics that impact the postoperative prognosis and recurrence of intracranial dissecting aneurysms (IDA) patients treated using multi-stent overlapping techniques.
Methods: Clinical data from 69 IDA patients treated with multistate-assisted spring coil embolization at the hospital between January 2017 and October 2023 were retrospectively reviewed, including clinical and imaging data gathered at admission and discharge. The prognosis was determined based on mRS grade at discharge, and the patients were divided into excellent prognosis (mRS 0-2 points) and poor prognosis (mRS 3-6 points).
Fourth-generation Pipeline Vantage flow diversion: First reported US experience of safety and feasibility.
Interv Neuroradiol
December 2024
Department of Neurology, University of Chicago, Chicago, IL, USA.
Article Synopsis
- The Pipeline Vantage embolization device is a new fourth-generation tool designed to treat intracranial aneurysms, and this study evaluates its safety and effectiveness.
- The research involved 12 patients, primarily women, with a variety of aneurysm types, and demonstrated a 100% success rate in device deployment without intraoperative complications.
- One postprocedural complication occurred, and the findings represent the first US analysis of this device's use in patients with intracranial aneurysms, highlighting its potential for treating both ruptured and unruptured cases.
Delayed Diagnosis of a Ruptured Distal Posterior Inferior Cerebellar Artery (PICA) Dissecting Aneurysm Presenting as Craniocervical Junction and Spinal Subdural Hematoma.
Cureus
October 2024
Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, JPN.
Posterior inferior cerebellar artery (PICA) dissecting aneurysms are rare and typically present with subarachnoid hemorrhage (SAH) or ischemic symptoms, with a high risk of rebleeding in the acute phase. This case presents an atypical ruptured PICA aneurysm with a hematoma confined to the craniocervical junction and cervical cord, leading to a delayed diagnosis - a 41-year-old male with an atypical presentation of headache and neck pain without neurological deficits. Initial magnetic resonance imaging (MRI) revealed a hematoma extending from the craniocervical junction to the cervical spinal cord without intracranial SAH, leading to misdiagnosis as spinal subdural hematoma.
View Article and Find Full Text PDFEfficacy and safety of the contralateral approach to vascular lesions in the vertebral artery: patient series.
J Neurosurg Case Lessons
November 2024
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Background: Endovascular treatment is preferred over microsurgical clipping for intracranial aneurysms in the posterior circulation. However, access to lesions, particularly those in the regions of the vertebral artery (VA) and the posterior inferior cerebellar artery (PICA), is technically challenging in terms of the vessel diameter of the ipsilateral VA or the branching angle of the PICA.
Observations: Nine cases of intracranial aneurysms in the region of the PICA, which were endovascularly treated with an approach beyond the vertebrobasilar junction (VBJ) from the contralateral VA in the last 4 years, are described herein.
[Microsurgery for Vertebral and Posterior Inferior Cerebellar Artery Aneurysms via Lateral Suboccipital Craniotomy].
No Shinkei Geka
September 2024
Department of Neurosurgery, Hokkaido University Graduate School of Medicine.
Article Synopsis
- * These aneurysms often need complex surgical interventions, such as skull base techniques and bypass procedures, rather than standard methods like clipping or coiling used for more common types.
- * The review discusses the clinical aspects, surgical history, and reconstruction techniques for these aneurysms, and includes a case study and video demonstrating current microsurgical practices.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!