EXTRACRANIAL ANEURYSM OF THE POSTERIOR INFERIOR CEREBELLAR ARTERY WITH AN ABERRANT ORIGINATIONCASE REPORT
2007
OBJECTIVE: Aneurysms of the extracranially originating
posterior inferior cerebellar arteryare very rare. An anatomic insight of its possible course and variations is necessary when confronting such extraordinary lesions. CLINICAL PRESENTATION: A 19-year-old man presented with the sudden onset of severe headaches. A physical examination was
positive onlyfor neck rigidity. Computed tomographic scans of the brain depicted
intraventricular hemorrhage. TECHNIQUE AND INTERVENTION: Four-vessel brain
digital subtraction angiographyrevealed an extracranial
posterior inferior cerebellar arteryarising extradurally from the right
vertebral arterybetween the C1 and C2 vertebrae, bearing a saccular aneurysm in an upper cervical intradural location. An
anterior inferior cerebellar artery-
posterior inferior cerebellar arteryvariant was also found on the left side. Computed tomographic angiography failed to unmask the lesion. The aneurysm was clipped through a suboccipital craniectomy and C1
laminectomy. CONCLUSION: The patient did well after surgery and was discharged from the hospital without neurological deficit. One can conclude that a comprehensive diagnostic approach oriented to the patient history and clinical data is mandatory to preclude such lesions evading the vigilant surgeon.
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