Extracranial aneurysm of the posterior inferior cerebellar artery with an aberrant origination: case report.

Abstract

OBJECTIVE:

Aneurysms of the extracranially originating posterior inferior cerebellar artery are 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 only for neck rigidity. Computed tomographic scans of the brain depicted intraventricular hemorrhage. TECHNIQUE AND INTERVENTION: Four-vessel brain digital subtraction angiography revealed an extracranial posterior inferior cerebellar artery arising extradurally from the right vertebral artery between the C1 and C2 vertebrae, bearing a saccular aneurysm in an upper cervical intradural location. An anterior inferior cerebellar artery-posterior inferior cerebellar artery variant 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.

• Authors: Seyed Ali Fakhr Tabatabai, Mehdi Zeinali Zadeh, Ali Tayebi Meybodi, Mohammad Hashemi
• Journal: Neurosurgery (Neurosurgery) Vol. 61 Issue 5 Pg. E1097-8; discussion E1098 (Nov 2007) ISSN: 1524-4040 [Electronic] United States
• PMID: 18091258 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Arteries (abnormalities, surgery)
• Cerebellum (blood supply)
• Humans
• Intracranial Aneurysm (etiology, surgery)
• Male
• Neurosurgical Procedures (methods)
• Treatment Outcome
• Vascular Surgical Procedures (methods)