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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention
Open Access

Dissecting Aneurysms of the Distal Segment of the Posterior Inferior Cerebellar Arteries: Clinical Presentation and Management

S.M. Lim, I.S. Choi, B.A. Hum and C.A. David
American Journal of Neuroradiology June 2010, 31 (6) 1118-1122; DOI: https://doi.org/10.3174/ajnr.A2014
S.M. Lim
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I.S. Choi
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B.A. Hum
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C.A. David
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    Fig 1.

    A 28-year-old man (patient 4) had serious head trauma from motor vehicle crash. A, The cerebral angiogram following the second SAH shows a small aneurysm at the anterior medullary segment of left PICA. B, Selective angiogram of the left vertebral artery at the time of treatment illustrates the PICA aneurysm increased in size in a day and diffuse spasm of the vertebral and basilar artery. C, Postembolization injection of the left vertebral artery demonstrates complete occlusion of the PICA at its origin with coils in the patent artery and the aneurysm.

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    Fig 2.

    An 80-year-old woman (patient 6) presented with sudden severe headache. A and B, Initial digital subtraction angiogram of the left vertebral artery in the frontal projection and 3D rotational angiogram show a fusiform irregular-shaped aneurysm at the anterior medullary segment with focal irregularity of left PICA, indicating dissection. C, The postembolization angiogram illustrates the dissecting aneurysm and parent artery are occluded.

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    Fig 3.

    A 35-year-old woman (patient 5) presented with Hunt and Hess grade III SAH. A, A lateral projection of the right vertebral angiogram demonstrates a 3 × 4 mm fusiform aneurysm at the lateral medullary segment of right PICA. B, The aneurysm is treated by endovascular occlusion of dissecting aneurysm and parent artery. The postocclusion angiogram in the lateral projection shows complete obliteration of the PICA trunk and the aneurysm. C, Five-year follow-up DS angiogram; note that the occluded PICA is recanalized without any growth of the aneurysm.

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  • Characteristics of 6 patients with peripheral dissecting aneurysms of the PICA

    Case No.Age/SexHunt and Hess GradeInitial CT and MR Imaging FindingsLocation of AneurysmTreatmentRecurrent AneurysmOutcome
    150/FIntracerebellar hematomaRight telovelomedullarEndovascularYesExcellent
    262/FMural hematomaLeft lateral medullarySurgeryNoExcellenta
    365/M2Subarachnoid hemorrhage, intraventricular hemorrhageLeft tonsilomedullaryEndovascularNoGood
    428/M5Subarachnoid hemorrhage, subdural hematoma, contusionLeft anterior medullaryEndovascularNoGood
    535/F3Subarachnoid hemorrhage, intraventricular hemorrhageRight lateral medullaryEndovascularNoExcellent
    680/F1Subarachnoid hemorrhage, intraventricular hemorrhageLeft anterior medullaryEndovascularNoExcellent
    • a Died of renal cell carcinoma 1 year after treatment of dissection.

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American Journal of Neuroradiology: 31 (6)
American Journal of Neuroradiology
Vol. 31, Issue 6
1 Jun 2010
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S.M. Lim, I.S. Choi, B.A. Hum, C.A. David
Dissecting Aneurysms of the Distal Segment of the Posterior Inferior Cerebellar Arteries: Clinical Presentation and Management
American Journal of Neuroradiology Jun 2010, 31 (6) 1118-1122; DOI: 10.3174/ajnr.A2014

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Dissecting Aneurysms of the Distal Segment of the Posterior Inferior Cerebellar Arteries: Clinical Presentation and Management
S.M. Lim, I.S. Choi, B.A. Hum, C.A. David
American Journal of Neuroradiology Jun 2010, 31 (6) 1118-1122; DOI: 10.3174/ajnr.A2014
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Cited By...

  • Endovascular treatment of posterior inferior cerebellar artery aneurysms: a 7-year single-center experience
  • Endovascular parent vessel sacrifice in ruptured dissecting vertebral and posterior inferior cerebellar artery aneurysms: clinical outcomes and review of the literature
  • Onyx embolization in distal dissecting posterior inferior cerebellar artery aneurysms
  • Endovascular treatment of ruptured dissecting aneurysms of the posterior inferior cerebellar artery
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