MICROSURGERY OF ANEURYSM WITHIN THE FOURTH SEGMENT OF LEFT VERTEBRAL ARTERY AND POSTERIOR INFERIOR CEREBELLAR ARTERY

Abstract

Here we describe the successful surgical treatment of the patient with aneurysm of the posterior inferior cerebellar artery (PICA), an extremely rare vascular disease. As the optimal surgical treatment for such pathology has not been conclusively determined, we performed a decompressive craniotomy of the posterior cranial fossa following clipping of the aneurysm within the fourth segment of the left vertebral artery and left PICA. In spite of technical difficulties, detailed neuroimaging permitted a thorough assessment of blood vessel topography. The selected approach has led to the favorable in-hospital and 2-year outcome. We suggest that the treatment of PICA aneurysm should be based on a complete assessment of the contralateral vertebral artery blood supply. In the case of its dysplasia, clipping should be performed avoiding the occlusion of the vertebral artery on the aneurysmal side. This was achieved in the abovementioned patient due to careful neuroimaging and detailed planning of surgery.

Keywords

• нейрохирургия
• аневризма левой позвоночной - левой задней нижней мозжечковой артерий
• микрохирургическое лечение
• мешотчатая артериальная аневризма головного мозга
• neurosurgery
• posterior inferior cerebellar artery
• aneurysm
• microsurgery
• saccular cerebral aneurysm