case_images: PMC9710451_01
case_images: Images of described patient. A non-enhanced head CT shows subarachnoid (a) and intraventricular (b) hemorrhage. A CTA (c) shows a vascular malformation with characteristics similar to PAM. d-f DSA reveals right PICA PAM associated with 2 aneurysms (arrows). g, h A 1-year follow-up image shows a stable PAM, no aneurysms, and an anatomical variant of the left PICA originating from the right vertebral artery. CT, computed tomography; CTA, computed tomography angiography; DSA, digital subtraction angiography; L, left side; PAM, pure arterial malformation; PICA, posterior inferior cerebellar artery; R, right side.
case_images: cee-0012-0116-g01.jpg
case_images: PMC9710451_01_cee-0012-0116-g01.jpg
case_images: F1
case_images: A non-enhanced brain computed tomography (CT) scan revealed diffuse and thick subarachnoid and intraventricular hemorrhage (Fig. 1a, b). A CT angiography (CTA) study raised suspicion of a PICA aneurysm (Fig. 1c). The patient consequently underwent cerebral digital subtraction angiography (DSA), which revealed a PICA PAM associated with two saccular aneurysms (Fig. 1d-f). At 1-year follow-up, the patient was neurologically intact and imaging showed a stable PAM and no aneurysms (Fig. 1g, h).