title: [Surgical treatment of vertebral artery-posterior inferior cerebellar artery dissecting aneurysms].
abstract: OBJECTIVE
  To study an effective method for vertebral artery-posterior inferior cerebellar artery (VA-PICA) dissecting aneurysms.
  
  
  METHODS
  Five patients with VA-PICA dissecting aneurysms were treated surgically between December 2007 and February 2010, who were all males, aged from 40 to 55 years. Four of them presented with subarachnoid hemorrhage (SAH), 1 of them suffered from an intermittent headache on occipital area about 4 months. All the aneurysms were trapped via a far-lateral approach after revascularization of the PICAs by occipital artery-posterior inferior cerebellar artery (OA-PICA) bypass.
  
  
  RESULTS
  Among the 5 patients, 1 of them got a good outcome without any neurological deficit after surgery, 3 of them had postoperative lower cranial nerve palsy, 1 of them complicated with bleeding in the operative field after postoperative antithrombotic treatment, and suffered from contralateral hemiplegia after second surgery of removing hematoma. Postoperative cerebral angiographies (received by 2 patients) and CT angiographies (received by 3 patients) all showed patent bypasses and no filling of the aneurysms. During the follow-up from 2 to 29 months, 4 patients got good outcomes, 1 patient still suffered from moderate hemiplegia.
  
  
  CONCLUSIONS
  Trapping the aneurysms after revascularization of PICA by OA-PICA bypass should be an effective method to treat the VA-PICA dissecting aneurysms, but individualized strategies also need to be considered based on different cases.
authors.affiliation: Department of Neurosurgery, FuXing Hospital Affiliated to Capital Medical University, Beijing 100093, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Tang
authors.forename: Xiang-En
authors.initials: XE
authors.lastname: Shi
authors.forename: Yong-Li
authors.initials: YL
authors.lastname: Zhang
authors.forename: Zhong-Qing
authors.initials: ZQ
authors.lastname: Zhou
mesh_terms: D000328:Adult; D002531:Cerebellum / Q000098:blood supply*; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014711:Vertebral Artery