Clinical presentation and treatment of distal posterior inferior cerebellar artery aneurysms: report on 5 cases.
BACKGROUND
Aneurysms of the PICA are uncommon. Most of them arise at the PICA origin from the VA, whereas distal PICA aneurysms are exceptional. A retrospective analysis of 457 patients with SAH treated in our hospital found 5 patients with 6 distal PICA aneurysms (approximately 1% of SAHs).


METHODS
All patients were female, with a mean age of 54 years. A 4-vessel cerebral angiogram performed immediately after admission showed an aneurysm located on the distal PICA. One patient was treated by an endovascular approach, and 3 patients were treated by surgical approach. The last patient had 2 distal high-flow aneurysms located on the distal PICA, which was the main arterial feeder of an AVM. The patient refused surgery or endovascular therapy. All 4 treated patients had good outcome at 3-month clinical follow-up.


CONCLUSIONS
Distal PICA aneurysms are exceptionally rare and may be treated successfully with surgical or endovascular techniques. The therapeutic strategy, either surgical or endovascular, should be selected according to the condition of the patient, the arterial and aneurysmal morphology, and the preference of the medical team.
Li
Xue-en
XE
Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, China.
Wang
Yun-yan
YY
Li
Gang
G
Jia
De-ze
DZ
Liu
Xiang-hui
XH
Gao
Jin
J
Li
Xin-gang
XG
D000328:Adult; D000368:Aged; D002531:Cerebellum / Q000098:blood supply*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D011379:Prognosis; D013525:Surgical Instruments