Clinical characteristics and surgical treatment of distal posterior inferior cerebellar artery aneurysms (a report of 8 cases)

Objective To investigate the clinical Characteristics and the surgical treatment of distal posterior inferior cerebellar artery (PICA) aneurysms. Methods The clinical data of 8 patients with distal PICA aneurysms, of whom, 6 underwent microsurgery through the median suboccipital approach and 2 through far-lateral suboccipital approach from January, 2008 to March, 2010 in our hospital, were analyzed retrospectively. The clinical data included the clinical manifestations, characteristics of imaging, surgical methods and prognoses in all the patients. The external ventricular drainage was performed during acute phase in 3 patients with intraventricular hemorrhage. Results The aneurysmal necks were successfully clipped in 6 patients and the aneurysms were isolated and resected in 2. All the patients were followed up 3 months to 2 years. No aneurysms recurred in 5 patients receiving 3D-CTA examination. The ventriculo-peritoneal shunt was performed due to hydrocephalus in 2 patients. GOS was 5 points in 6 patients, 4 in 1 and 3 in 1. Conclusions The main clinical manifestations include the hemorrhage in the fourth ventricle or cerebellar vermis and hydrocephalus. The 3D-CTA is helpful to the diagnosis of distal PICA aneurysms. Once the diagnosis is definitely made, the surgery should be performed as quickly as possible in order to improve the prognoses in the patients with distal PICA aneurysms.