A Case of Proximal Posterior Inferior Cerebellar Artery (PICA) Aneurysm Treated with PICA-to-PICA Bypass and Trapping Surgery: Comparison with Occipital Artery-PICA Bypass

• DOI: 10.2176/jns-nmc.2022-0028
• Publication Date: 2022-05-30T22:15:32Z
• Authors: Yusuke SAKAMOTO; Kenko MAEDA; Masaya TAKEMOTO; Jungsu CHOO; Mizuka IKEZAWA; Ohju FUJITA; Fumihiro SAGO; Daiki SOMIYA; Akira IKEDA
• Keywords: Pica (typography); Occipital artery

Posterior inferior cerebellar artery (PICA) aneurysms often require cerebral vascular reconstruction for surgical treatment because of their characteristic morphology. Despite its potential complications, the occipital artery-to-posterior (OA-PICA) bypass is a typical versatility. Although few cases intracranial-to-intracranial have been reported, this type only regarded as an alternative to OA-PICA uncertainty feasibility and risk ischemic complications. In article, we report case proximal PICA ruptured aneurysm that was treated with PICA-to-PICA (PICA-PICA) bypass. A 79-year-old man presented chief complaint sudden, severe headache disturbances in consciousness. Radiological examination revealed right fusiform aneurysm. The patient had many systemic disorders such microscopic polyangiitis steroid-induced diabetes mellitus could caused wound dehiscence cerebrospinal fluid (CSF) leakage. We performed PICA-PICA trapping surgery rather than avoid skin problems CSF postoperative course uneventful, discharged on day 64 without any neurological disorders. comparison bypass, less likely cause leakage although it carries specific complications requires advanced techniques. For some patients disorders, be optimal option