J Korean Neurosurg Soc.
2001 Jan;30(1):66-72.
Multiple Dissecting Aneurysms of the PICA Trunk: Case Report
- Affiliations
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- 1Department of Neurosurgery, Kosin University Gospel Hospital, Pusan, Korea.
- 2Depatment of Neurosurgery, Catholic University, Our Lady of Mercy Hospital, Inchon, Korea.
Abstract
- A patient with multiple dissecting aneurysms of a posterior inferior cerebellar artery trunk who presented with SAH is reported. A 58-year-old woman presented with sudden occipital headache, dizziness and vomiting. The intial vertebral angiography revealed a suspicious pearl and string sign at the proximal posterior inferior cerebellar artery(PICA) segment. After 2 weeks , follow up angiography showed a progression of the proximal PICA dissection and newly developed dissecting aneurysm of the distal PICA segment. A far lateral suboccipital transcondylar appoach confirmed two dissecting aneurysms at distant sites of the PICA trunk. The dissection segments were wrapped with muslin wrap , which preserved the flow through the PICA and brain stem perforators. The angiographys at 3 weeks and 6 months after operation revealed serial disappearance of the dissecting aneurysms which is distal to proximal. The diagnosis , course and treatment of the dissecting aneurysms of the PICA are discussed with literature review.
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