{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:25:52Z","timestamp":1791440752532,"version":"4.3.3"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Aneurysms on the posterior inferior cerebellar artery (PICA) may not be the major part of intracranial aneurysm. Especially, an aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery has abnormal anatomical characteristics in the vessel wall and then causes stroke including subarachnoid hemorrhage. This case report explores the direct resection of a ruptured aneurysm associated with the bilateral anomalous anastomotic artery of PICA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The case report discusses a 53-year-old woman who suffered from sudden severe headache and vomiting for more than 3\u2009h admitted to our hospital. Emergency computed tomography (CT) revealed subarachnoid hemorrhage (SAH) in the third and fourth ventricles. Preoperative 3 Dimensions-digital subtraction angiography (3-D DSA) indicated a ruptured aneurysm located on the bilateral posterior inferior cerebellar anastomotic artery. Postoperative pathological findings indicated the characteristics of parent artery PICA and control aneurysm. The authors performed an overview of PICA aneurysms with anomalous variation in the Pubmed, Web of Science, and Medline databases. The search was until 1 August 2023. Related terms \u201cposterior inferior cerebellar artery\u201d And \u201caneurysm\u201d AND \u201canatomical variants\u201d were used to search the review. The reasons for anomalous variation anastomosis between bilateral PICAs were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The aneurysm was resected successfully. Post-operative 3-D DSA revealed the disappearance of the aneurysm. The vessel wall of anastomotic PICA showed neovascularized hyperplasia, abnormal arrangement of smooth muscle, CD31+ endothelial cells, and SMA+ smooth muscle cells. In contrast, when it came to aneurysm, the wall at the location of the fracture thinned, which could be used to explain that the local nodular protrusion was formed and CD31+ endothelial cells existed. No neurological deficits were found at her 1-year follow-up visit (mRS score of 0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Direct resection of ruptured aneurysm associated with bilateral anomalous posterior inferior cerebellar anastomotic arteries was an effective treatment and careful consideration of the anatomical characteristics concerning the interesting aneurysm and the variant PICA was critical for sate treatment. Also, the literature on the lesion was reviewed.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1281124","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T12:11:48Z","timestamp":1701432708000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Resection of ruptured aneurysm associated with bilateral anomalous posterior inferior cerebellar anastomotic arteries: case report and review of literature"],"prefix":"10.3389","volume":"14","author":[{"given":"Qingdong","family":"Han","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongqi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yabo","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/978-3-030-63453-7_5","article-title":"Microneurosurgical Management of Posterior Inferior Cerebellar Artery Aneurysms: results of a consecutive series","volume":"132","author":"Del Maestro","year":"2021","journal-title":"Acta Neurochir Suppl"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"396","DOI":"10.2176\/nmc.43.396","article-title":"Bilateral anomalous posterior inferior cerebellar artery-anterior inferior cerebellar artery anastomotic arteries associated with a ruptured cerebral aneurysm--case report","volume":"43","author":"Fujimura","year":"2003","journal-title":"Neurol Med Chir"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.wneu.2018.11.051","article-title":"Challenges in the Management of a Ruptured Bihemispheric Posterior Inferior Cerebellar Artery Aneurysm","volume":"122","author":"Tan","year":"2019","journal-title":"World Neurosurg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"E314","DOI":"10.1093\/ons\/opaa016","article-title":"Reimplantation bypass using one limb of a double-origin posterior inferior cerebellar artery for treatment of a ruptured fusiform aneurysm: case report","volume":"19","author":"Lang","year":"2020","journal-title":"Oper Neurosurg"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.7461\/jcen.2023.E2022.10.011","article-title":"Endovascular treatment for anterior inferior cerebellar artery-posterior inferior cerebellar artery (AICA-PICA) common trunk variant aneurysms: technical note and literature review","author":"Ku","year":"2023","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"596","DOI":"10.3171\/2016.1.JNS152099","article-title":"Anterior spinal and bulbar artery supply to the posterior inferior cerebellar artery revealed by a ruptured aneurysm: case report","volume":"126","author":"Gabrieli","year":"2017","journal-title":"J Neurosurg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E388","DOI":"10.1227\/01.NEU.0000199344.63306.DD","article-title":"Aneurysm of the anterior inferior cerebellar artery-posterior inferior cerebellar artery variant: case report with anatomical description in the cadaver","volume":"58","author":"Baskaya","year":"2006","journal-title":"Neurosurgery"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1016\/j.clineuro.2009.05.012","article-title":"Diagnosis and surgical management of extracranial PICA aneurysms presenting through subarachnoid haemorrhage: case report and review of the literature","volume":"111","author":"Dammers","year":"2009","journal-title":"Clin Neurol Neurosurg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.wneu.2018.06.085","article-title":"Clipping of ruptured aneurysm of lateral spinal artery associated with anastomosis to distal posterior inferior cerebellar artery: a case report","volume":"117","author":"Germans","year":"2018","journal-title":"World Neurosurg"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"127","DOI":"10.3171\/jns.2002.96.1.0127","article-title":"Ruptured aneurysm on a double origin of the posterior inferior cerebellar artery: a pathological entity in an anatomical variation. Report of two cases and review of the literature","volume":"96","author":"Pasco","year":"2002","journal-title":"J Neurosurg"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1281124\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T12:11:50Z","timestamp":1701432710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1281124\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":10,"alternative-id":["10.3389\/fneur.2023.1281124"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1281124","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,1]]},"article-number":"1281124"}}