title: Intraoperative visualization of bilateral thrombosis in the posterior inferior cerebellar artery apparent in the telovelomedullary segment.
abstract: Unilateral posterior inferior cerebellar artery (PICA) thrombosis is frequent. However, bilateral PICA thrombosis is rare. Herein we report about an intraoperative visualization of a bilateral thrombosis of the telovelomedullary segment of the PICA. A 74-year-old woman was admitted to our department on day two of a bilateral PICA thrombosis with developing cerebellar infarction. Her Glasgow Coma Scale score dropped from 15 to 13, and cranial computed tomography revealed compression of the fourth ventricle with consecutive occlusive hydrocephalus. After the insertion of an external ventricular drainage, the patient underwent urgent suboccipital decompressive craniectomy with removal of infarcted cerebellar tonsils, which allowed the bilateral visualization of the thrombosed telovelomedullary segments. The surgical access may offer surgical therapeutic options in a hyperacute occlusion, such as thromb-/embolectomy or bypass procedures.
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Tellstraße, 5001 Aarau, Switzerland.
authors.forename: Edin
authors.identifier: 0000-0001-8943-0290
authors.initials: E
authors.lastname: Nevzati
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Tellstraße, 5001 Aarau, Switzerland.
authors.forename: Bawarjan
authors.initials: B
authors.lastname: Schatlo
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Tellstraße, 5001 Aarau, Switzerland.
authors.forename: Ali-Reza
authors.identifier: 0000-0001-7078-6668
authors.initials: AR
authors.lastname: Fathi
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Tellstraße, 5001 Aarau, Switzerland.
authors.forename: Javier
authors.initials: J
authors.lastname: Fandino
authors.affiliation: Department of Neurosurgery, Kantonsspital Aarau, Tellstraße, 5001 Aarau, Switzerland.
authors.forename: Carl
authors.identifier: 0000-0003-2529-2022
authors.initials: C
authors.lastname: Muroi