Publication Date
7-1-2024
Journal
Journal of NeuroInterventional Surgery
DOI
10.5469/neuroint.2024.00136
PMID
38714486
PMCID
PMC11222686
PubMedCentral® Posted Date
5-8-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Aneurysm, Endovascular treatment, Extracranial, Vascular variant, Coil embolization
Abstract
Extracranial vascular pathology uncommonly causes intracranial subarachnoid hemorrhage (SAH). Among possible lesions are aneurysms at the craniocervical junction arising from a posterior inferior cerebellar artery (PICA) with an extradural origin. We describe a case of a 55-year-old female presenting with a sudden and severe headache. A computed tomography scan revealed a SAH within the fourth ventricle and cervical spinal canal, and a ruptured saccular aneurysm on a PICA with extradural C2-origin. Despite difficult access anatomy, endovascular treatment was feasible and resulted in subtotal initial occlusion and preservation of distal PICA flow. Upon 3-month follow-up, the aneurysm was completely occluded with a patent PICA. The patient's clinical status remained stable at the 1.5-year follow-up. In conclusion, we present a rare case of an aneurysm originating from a PICA with extradural C2-origin that was treated endovascularly with preservation of the PICA.