{"id":"f502f85d-6eb1-40c9-bff7-fe6def0535c0","slug":"ruptured-aneurysm-at-the-cortical-segment-of-the-distal-posterior-inferior-cerebellar-artery-associated-with-hemodynamic-stress-after-basilar-artery-occlusion","title":"Ruptured aneurysm at the cortical segment of the distal posterior inferior cerebellar artery associated with hemodynamic stress after basilar artery occlusion","authors":["Akiko Marutani","Ichiro Nakagawa","Hun Soo Park","Kentaro Tamura","Yasushi Motoyama","Hiroyuki Nakase"],"abstract":"Background: A distal posterior inferior cerebellar artery (PICA) de novo aneurysm at the cortical segment after atherosclerotic basilar artery occlusion is extremely rare. Here, we report the case of a ruptured distal PICA de novo aneurysm 8 years after basilar artery occlusion. Case Description: A 75-year-old man experienced sudden disturbance of consciousness; computed tomography demonstrated cerebellar and subarachnoid hemorrhage due to a ruptured distal PICA aneurysm. Neck clipping of the aneurysm prevented re-rupture initially, and superficial temporal artery-superior cerebellar artery (STA-SCA) bypass was performed 3 months after admission. Postoperative angiography confirmed patency of the bypass, and the patient was discharged without any new neurological deficits. Conclusion: This report describes a case of de novo development of a saccular distal PICA aneurysm after atherosclerotic basilar artery occlusion. We believe that increased hemodynamic stress at the PICA might have contributed to the occurrence and rupture of the aneurysm. STA-SCA bypass, introduced in the territory of the cerebellar hemisphere, reduces hemodynamic stress, which would prevent the occurrence of de novo aneurysm and recurrent bleeding.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/f502f85d-6eb1-40c9-bff7-fe6def0535c0/featured/hero-1782420895026.png","publishDate":"2016-12-21T00:00:00.000Z","doi":"10.4103/2152-7806.196377","categories":["Neurovascular","Case Report"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2017/01/8234/SNI-7-1065.pdf"}