{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:48:44Z","timestamp":1792259324834,"version":"4.4.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>BACKGROUND AND IMPORTANCE:<\/jats:bold>\n                    Aneurysms affecting double origin (DO) posterior inferior cerebellar artery (PICA) variants are rare. Most reports describe endovascular occlusion of the affected branch to treat the aneurysm, but we describe a patient in which open surgical sacrifice of 1 branch resulted in insufficient perfusion.\n                  <\/jats:p>\n                  <jats:p>This case and our review of PICA embryology provide insight into treatment of aneurysms affecting duplicated intracranial vessels.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>CLINICAL PRESENTATION:<\/jats:bold>\n                    We report the only case of open surgical treatment of an aneurysm affecting a leg of a DOPICA. A 42-year-old woman presenting with the worst headache of her life was found to have a DOPICA aneurysm and initially treated by trapping the aneurysm. Intraoperative indocyanine green imaging revealed insufficient perfusion through the caudal branch, which was remediated by end-to-end anastomosis to preserve flow through both origins. The patient made a full recovery.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>CONCLUSION:<\/jats:bold>\n                    Treating a DOPICA aneurysm by sacrificing 1 of the origins is not possible for all patients. This first report of open surgical treatment of a DOPICA leg aneurysm suggests that 1 or both branches may be required for sufficient perfusion, and the unique embryology of DOPICA development suggests a possible mechanism.\n                  <\/jats:p>","DOI":"10.1093\/ons\/opx002","type":"journal-article","created":{"date-parts":[[2017,2,28]],"date-time":"2017-02-28T02:25:10Z","timestamp":1488248710000},"page":"E8-E12","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Surgical Treatment of a Double Origin Posterior Inferior Cerebellar Artery Aneurysm and Insights From Embryology: Case Report and Literature Review"],"prefix":"10.1227","volume":"13","author":[{"given":"Michael A.","family":"Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred P.","family":"See","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Aziz-Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirav J.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,6]]},"reference":[{"issue":"4","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1148\/rg.294085730","article-title":"Normal variants of the cerebral circulation at multidetector CT angiography","volume":"29","author":"Dimmick","year":"2009","journal-title":"Radiographics"},{"issue":"3","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"42","DOI":"10.12659\/PJR.889403","article-title":"Variants of cerebral arteries - anterior circulation","volume":"78","author":"Makowicz","year":"2013","journal-title":"Pol J Radiol"},{"issue":"3","key":"bib3-20240909","doi-asserted-by":"crossref","first-page":"567","DOI":"10.2214\/ajr.118.3.567","article-title":"Anomalies of the middle cerebral artery: accessory artery, duplication, and early bifurcation","volume":"118","author":"Teal","year":"1973","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"issue":"10-11","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/PL00013718","article-title":"Maldevelopmental pathology of the vertebral artery in infancy and childhood","volume":"16","author":"Giuffre","year":"2000","journal-title":"Childs Nerv Syst"},{"issue":"6","key":"bib5-20240909","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.3174\/ajnr.A0498","article-title":"Developmental anatomy of the distal vertebral artery in relationship to variants of the posterior and lateral spinal arterial systems","volume":"28","author":"Siclari","year":"2007","journal-title":"AJNR Am J Neuroradiol."},{"issue":"5","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s00276-013-1208-z","article-title":"Variations of the cerebellar arteries at CT angiography","volume":"36","author":"Pekcevik","year":"2014","journal-title":"Surg Radiol Anat"},{"issue":"2","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"235","DOI":"10.3171\/jns.1985.63.2.0235","article-title":"The lateral spinal artery of the upper cervical spinal cord. 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