Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Multiple Dissecting Aneurysms of the PICA Trunk - Case Report -

다발성 후하소뇌동맥 해리성 동맥류 - 증 례 보 고 -

  • Kim, Jong Tae (Depatment of Neurosurgery, Catholic University, Our Lady of Mercy Hospital) ;
  • Kim, Han Kyu (Department of Neurosurgery, Kosin University Gospel Hospital)
  • 김종태 (가톨릭대학교 의과대학 성모자애병원 신경외과학교실) ;
  • 김한규 (고신대학교 의과대학 부속 복음병원 신경외과학교실)
  • Received : 1999.11.15
  • Accepted : 2000.09.27
  • Published : 2001.01.28
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Abstract

Apatient 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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