Management of distal posterior inferior cerebellar artery aneurysms.

BACKGROUND: Most of the posterior inferior cerebellar artery (PICA) aneurysms arise at the vertebral artery-PICA junction; distal PICA aneurysms are rare. Their clinical features and treatments are not fully understood. METHODS: This was a retrospective study. We reported 9 patients with the distal PICA aneurysms treated by surgical clipping or endovascular embolization in our neurosurgical center. RESULTS: All patients experienced sudden onset of headache with subarachnoid hemorrhage. The location of PICA aneurysms was at the anterior-medullary (n = 4), tonsillomedullary (TM) (n = 1), and telovelotonsillar (n = 4). Surgical clipping was performed in 3 and endovascular coil in 6 patients. All the PICA aneurysms were occluded with parent artery preservation, and all of the patients achieved good recovery. CONCLUSIONS: Distal PICA aneurysm is exceptionally rare; it could be treated successfully with surgical clipping or endovascular treatments.