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Mirror-image aneurysms of posteroinferior cerebellar artery (PICA) – simultaneous endovascular treatment. Case report

Paweł Kolasa, Zbigniew Kaurzel, Maciej Kolasa

CaseRepClinPractRev 2004; 5:318-323

ID: 12294

Published: 2004-04-20

Introduction: Rare location of mirror-image aneurysms of posteroinferior cerebellar artery is described as well as the choice of the method of treatment and its application.Case Report: The patient was admitted to hospital on the 10th day after subarachnoid haemorrhage; conscious and in verbal contact. Clinical state GCS13, H-H III with distinct nuchal rigidity and Kernig’s sign. Endovascular treatment with bilateral embolisation of two aneurysms – one immediately after the other at one operative sitting was performed. Good radiological result was achieved after the embolisation. The long term follow- up results demonstrate improvement of patent’s clinical state.Conclusions: This case demonstrates rare mirror-image aneurysms of posteroinferior cerebellar arteries. To our knowledge, it is the second case of mirror-image aneurysms at the PICA origin, reported in literature, it is the first described case of simultaneous embolisation of bilateral aneurysms in this location.

Keywords: mirror-image aneurysms, multiple aneurysms, posteroinferior cerebellar artery, subarachnoid aemorrhage, endovascular treatment