case_images: PMC10722183_01
case_images: Resection of ruptured aneurysm associated with bilateral anomalous posterior inferior cerebellar anastomotic arteries.
case_images: fneur-14-1281124-g001.jpg
case_images: PMC10722183_01_fneur-14-1281124-g001.jpg
case_images: fig1
case_images: Emergency CT revealed subarachnoid hemorrhage in the localization of the third and fourth ventricles (Figures 1A,B). Preoperative DSA and 3-D DSA indicated a ruptured aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery (Figures 1C-E). The intraoperative image indicated an aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery with some arterial branches on the back of the medulla (Figures 1F,G). Bilateral posterior inferior cerebellar arteries were trapped prior to resection of the ruptured PICA aneurysm (Figures 1H,I). PICAs, the aneurysm was resected successfully and intraoperative ICG showed the disappearance of the aneurysm (Figures 1J,K). Post-operative CT (Figure 1L), post-operative DSA, and 3-D DSA revealed the obliteration of the aneurysm (Figures 1M-P). Postoperative pathological findings indicated the characteristics of the variant aneurysm.
case_images: Pathological findings in the vessel wall of variant posterior inferior cerebellar anastomotic artery.
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case_images: PMC10722183_01_fneur-14-1281124-g002.jpg
case_images: fig2
case_images: HE staining (Figure 2A) showed that the vessels were twisted, with uneven thickness of the vessel wall, obvious thickening of part of the vessel wall, and rupture of part of the vessel wall with bleeding.
case_images: Pathological findings in the vessel wall of control aneurysm.
case_images: fneur-14-1281124-g003.jpg
case_images: PMC10722183_01_fneur-14-1281124-g003.jpg
case_images: fig3
case_images: HE staining (Figure 3A, original magnification x40) showed that the arterial vessel wall was broken, the vascular endothelium extended outside the vessel wall along the fracture site, and the bleeding at the fracture site was significantly thinned.