An 87-year-old man hospitalized for subarachnoid hemorrhage showed a ruptured aneurysm arising from fenestration of the posterior inferior cerebellar artery. Endovascular treatment was selected and the aneurysm and superior limb were embolized completely using three coils. Fenestration of the posterior cerebellar artery is exceedingly rare. In addition, we present a first case of aneurysm as fenestration of the posterior inferior cerebellar artery that was definitively identified as a cause of bleeding.
MatsushitaYKawabataSKamoMet al.Ruptured aneurysm at the cortical segment of the posterior inferior cerebellar artery. J Clin Neurosci2006; 13: 777–781.
KatoKAsamiMWanifuchiH. Distal posterior inferior cerebellar artery aneurysm located at cranial loop of vertebral artery ended as PICA [article in Japanese]. Surgery for Cerebral Stroke2014; 42: 458–461.
10.
LesleyWS. Fenestration of the posterior inferior cerebellar inferior cerebellar artery. Cerebellum2008; 7: 240–241.
11.
LasjauniasPL. Segmental identity and vulnerability in cerebral arteries. Interv Neuroradiol2000; 6: 113–124.
12.
SerizawaTSaekiNYamauraA. Microsurgical anatomy and clinical significance of the anterior communicating artery and its perforating branches. Neurosurgery1997; 40: 1211–1218.
13.
FinlayHMCanhamPB. The layered fabric of cerebral artery fenestrations. Stroke1994; 25: 1799–1806.
14.
TheodosopoulosPVLawtonMT. Fenestration of the posteroinferior cerebellar artery: Case report. Neurosurgery2000; 47: 463–465.
15.
KumarSJustinEMMishraNK. Fenestrated posterior inferior cerebellar artery with concomitant vertebra-basilar junction fenestration and vertebral artery aneurysm. Clin Neuroradiol2012; 22: 235–237.
16.
LeeSHKohJSRyuCWet al.Fenestration of the double origin of the posterior inferior cerebellar artery associated with a contralateral vertebral artery dissection. Cerebellum2009; 8: 382–384.
17.
ChoYDHanMHLeeJYet al.Double origin of the posterior inferior cerebellar artery with juxta-proximal fenestration of caudal component. Surg Radiol Anat2011; 33: 271–273.
18.
BlackSPAnsbacherLE. Saccular aneurysm associated with segmental duplication of the basilar artery. A morphological study. J Neurosurg1984; 61: 1005–1008.
19.
AndrewsBTBrant-ZawadzkiMWilsonCB. Variant aneurysms of the fenestrated basilar artery. Neurosurgery1986; 18: 204–207.
20.
CromptonMR. The pathology of ruptured middle-cerebral aneurysms with special reference to the differences between the sexes. Lancet1962; 2: 421–425.
21.
BaskayaMKCoscarellaEJeaAet al.Aneurysm of the anterior inferior cerebellar artery-posterior inferior cerebellar artery variant: Case report with anatomical description in the cadaver. Neurosurgery2006; 58: E388.
22.
LiuIWHoBLChenCFet al.Vertebral artery terminating in posterior inferior cerebellar artery: A normal variation with clinical significance. PLoS One2017; 12: e0175264.
23.
LasjaniusPBerensteinAter BruggeKG. Surgical neuroangiography: Vol 1: Clinical vascular anatomy and variations, 2nd ed. Berlin, Heidelberg, New York: Springer-Verlag, 2001, pp. 246–247.
24.
PascoAThouvenyFPaponXet al.Ruptured aneurysm on a double origin of the posterior inferior cerebellar artery: A pathological entity in an anatomical variation. Report of two cases and review of the literature. J Neurosurg2002; 96: 127–131.
25.
MercierPHBrassierGFournierHDet al.Vascular microanatomy of the pontomedullary junction, posterior inferior cerebellar arteries, and the lateral spinal arteries. Interv Neuroradiol2008; 14: 49–58.
