Ruptured aneurysm originating from an aberrant medullary branch of the proximal posterior inferior cerebellar artery: case report.
OBJECTIVE
Aneurysms that arise from a small branch of the posterior inferior cerebellar artery (PICA) are very rare. All reported PICA branch aneurysms originated from the choroidal branches or PICA communicating branches. No aneurysms of the PICA medullary branch have been reported previously.


METHODS
A 62-year-old woman presented with a subarachnoid hemorrhage and intraventricular hemorrhage. Angiography showed a globular-shaped aneurysm arising from an aberrant branch of the anterior medullary segment of the left PICA. At the time of operation, the arterial branch was found to send some perforators into to the medulla oblongata and cervical spinal cord.


METHODS
Aneurysm trapping was performed. Postoperatively, the patient had a mild transient difficulty in swallowing that may have been caused by manipulation of the vagus nerve rootlets.


CONCLUSIONS
Aneurysms can develop from a proximal medullary branch of the PICA and lead to subarachnoid hemorrhage and intraventricular hemorrhage. Trapping can be judiciously attempted to treat this precarious aneurysm.
Phi
Ji Hoon
JH
Department of Neurosurgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Lee
Sang Hyung
SH
Son
Kyu Ri
KR
Chung
Young Seob
YS
D017542:Aneurysm, Ruptured / Q000473:pathology*; D000792:Angiography; D002531:Cerebellum / Q000098:blood supply*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008526:Medulla Oblongata / Q000098:blood supply*; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D014711:Vertebral Artery / Q000473:pathology*