PMC9020869_01
A, B: Cerebral angiography showing a 3.6-mm fusiform aneurysm with a bleb of the left PICA at the origin of the PICA from the vertebral artery (VA). Additionally, an AICA-PICA anastomosis parallel to the basilar artery (BA) is revealed.. C: 3D rotational angiography showing AICA-PICA anastomosis (white arrow).. D: Illustration of Fig. 1C. The AICA has two branches: the AICA-PICA anastomosis and the hemispheric branch and the PICA running along the lateral side of the medulla and bifurcating into the hemispheric and vermian branches. (Illustrated by (C) SAIKOU, INC.)
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Three-dimensional (3D) rotational angiography showed that the AICA has two branches: the AICA-PICA anastomosis and the hemispheric branch, with the PICA running along the lateral side of the medulla and bifurcating into the hemispheric and vermian branches (Fig. 1).
A: Postoperative 3D rotational angiography showing complete obliteration of the aneurysm, with the branches of the AICA and PICA being preserved.. B: Postoperative diffusion-weighted image showing no infarction in the medulla or left cerebellum.
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AICA-PICA segment were observed in the operative field. Aneurysm trapping was performed using titanium clips, and the vascular supply to the PICA branches was preserved via AICA-PICA anastomosis (Fig. 2A). PICA. Postoperative magnetic resonance imaging showed no infarction in the brainstem or cerebellum (Fig. 2B), and the patient's neurological condition improved greatly, except for bilateral abducens nerve palsy.