title: "True" posterior communicating aneurysms: Three cases, three strategies.
abstract: BACKGROUND
  The authors provide a review of true aneurysms of the posterior communicating artery (PCoA). Three cases admitted in our hospital are presented and discussed as follows.
  
  
  METHODS
  First patient is a 51-year-old female presenting with a Fisher II, Hunt-Hess III (headache and confusion) subarachnoid hemorrhage (SAH) from a ruptured true aneurysm of the right PCoA. She underwent a successful ipsilateral pterional craniotomy for aneurysm clipping and was discharged on postoperative day 4 without neurological deficit. Second patient is a 53-year-old female with a Fisher I, Hunt-Hess III (headache, mild hemiparesis) SAH and multiple aneurisms, one from left ophthalmic carotid artery and one (true) from right PCoA. These lesions were approached and successfully treated by a single pterional craniotomy on the left side. The patient was discharged 4 days after surgery, with complete recovery of muscle strength during follow-up. Third patient is a 69-year-old male with a Fisher III, Hunt-Hess III (headache and confusion) SAH, from a true PCoA on the right. He had a left subclavian artery occlusion with flow theft from the right vertebral artery to the left vertebral artery. The patient underwent endovascular treatment with angioplasty and stent placement on the left subclavian artery that resulted in aneurysm occlusion.
  
  
  CONCLUSIONS
  In conclusion, despite their seldom occurrence, true PCoA aneurysms can be successfully treated with different strategies.
authors: Department of Neurosurgery, Hospital Heliópolis, São Paulo, Brazil.
authors: Breno
authors: B
authors: Nery
authors: Department of Neurosurgery, Hospital Heliópolis, São Paulo, Brazil.
authors: Ricardo
authors: R
authors: Araujo
authors: Department of Neurosurgery, Hospital Heliópolis, São Paulo, Brazil.
authors: Bruno
authors: B
authors: Burjaili
authors: Department of Neurosurgery, Brigham and Women's Hospital, Harvard University School of Medicine, Boston, MA, USA.
authors: Timothy R
authors: TR
authors: Smith
authors: Department of Neurosurgery, Hospital Heliópolis, São Paulo, Brazil.
authors: Jose Carlos
authors: JC
authors: Rodrigues
authors: Department of Neurosurgery, Hospital Heliópolis, São Paulo, Brazil.
authors: Marcelo Nery
authors: MN
authors: Silva
keywords: Etiology; physiopathology; treatment; true posterior communicating artery aneurysms