Abstract
Although the anatomy of the posterior inferior cerebellar artery (PICA) is highly variable, a solitary PICA supplying both hemispheres of the cerebellum is rare. A 76-year-old woman presented with severe headache and subsequent loss of consciousness and was admitted to our hospital. Initial computed tomography showed subarachnoid hemorrhage. Three-dimensional digital subtraction angiography revealed a saccular aneurysm arising from the right vertebral artery (VA)-PICA bifurcation. The PICA branching from the right VA was enlarged, tortuous, and crossed the midline to supply both cerebellar hemispheres. This right PICA was interpreted as a bihemispheric PICA. Recognizing this variant preoperatively could help prevent complications of surgery. Careful follow-up studies are necessary in cases with bihemispheric PICA to monitor for the development of aneurysm at the junction between the bihemispheric PICA and the VA or the distal portion of the bihemispheric PICA.
Copyright
Association for Helping Neurosurgical Sick People. This is an open
access article published by Thieme under the terms of the Creative
Commons Attribution-Non Derivative-Non Commercial License, permitting
copying and reproduction so long as the original work is given
appropriate credit.
Contents may not be used for commercial purposes, or
adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/
)
This is an open-access article distributed under the terms of the
Creative Commons Attribution-Non Commercial-No Derivatives License, which
permits unrestricted reproduction and distribution, for non-commercial
purposes only; and use and reproduction, but not distribution, of
adapted material for non-commercial purposes only, provided the original
work is properly cited.
