The authors report an unusual surgical treatment for an aneurysm on the left peripheral posterior inferior cerebellar artery (PICA). The computed tomographic scan showed subarachnoid haemorrhage and a haematoma in the left cerebellar region close to the fourth ventricle. The 3D CT angiography demonstrated an aneurysm on the left peripheral PICA which was confirmed on four-vessel angiography. The aneurysm was approached through a posterior suboccipital craniotomy and the PICA was reconstructed with multiple clips. The literature concerning peripheral PICA aneurysms and their treatment is reviewed and discussed.
Posterior inferior cerebellar artery - aneurysm - clip - reconstruction - fourth ventricle