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Japanese

Ruptured Aneurysm of Distal Posterior Inferior Cerebellar Artery Located at Caudal Loop Shinya Oshiro 1 , Takuma Kawahara 1 , Seisaburo Sakamoto 1 , Hirokazu Ohnishi 1 , Tadahiro Ohmura 1 , Hitoshi Tsugu 1 , Takeo Fukushima 1 1Department of Neurosurgery, Faculty of Medicine, Fukuoka University Keyword: communicating artery , distal aneurysm , hemodynamic stress , PICA pp.173-177
Published Date 2007/2/1
DOI https://doi.org/10.11477/mf.1416100022
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Abstract

 We report an unusual case of subarachnoid hemorrhage (SAH) due to ruptured aneurysm originating at the caudal loop of posterior inferior cerebellar artery (PICA). The patient was a 77-year-old female presented with a sudden onset of headache and vomiting. Initial CT scan demonstrated a SAH with thick hematoma mainly in the cisterna magna. Vertebral angiogram revealed a saccular aneurysm arising from the tonsillomedullary segment of the left PICA, and communicating artery with supplying a territory of contralateral vermis as an anastmotic vessel. At surgery,no vessel branches were confirmed in the vicinity of the aneurysm,and this aneurysm was successfully clipped. In the fetus,numerous basilar and vertebral arteries are organized in plexiform formations around the brain stem. It has been suggested that the pathogenesis of such aneurysm or communicating artery could be related with a remnant of a primitive vertebrobasilar anastomosis. Based on these considerations, congenital vessel-wall weakness and hemodynamic stress associated with communicating artery may contribute to the development of distal PICA aneurysms.


Copyright © 2007, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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