Abstract
Anterior inferior cerebellar artery–posterior inferior cerebellar artery (AICA-PICA)
variant or common trunk is seen frequently in vertebral angiograms as PICA is found
to be hypoplastic or absent in approximately 20 to 25% of patients. There have been
very few case reports of aneurysm arising in AICA-PICA variant. Intrameatal AICA aneurysms
are also rare, with no reports involving AICA-PICA variant till date. Neurosurgical
approach and clipping have been proposed as first-line treatment option for intrameatal
AICA aneurysms. The authors report a case of a young woman presenting with subarachnoid
hemorrhage, found to have a right AICA-PICA variant aneurysm in intrameatal location.
The patient underwent coiling with parent vessel occlusion after an unsuccessful attempt
at surgical management of the same. She recovered without any postprocedure complication.
This case report highlights the fact that endovascular approach can be used to manage
distal AICA/AICA-PICA variant or intrameatal aneurysm with added advantage of avoiding
the postprocedure complications associated with surgical management of the same.
Keywords
AICA-PICA variant - intrameatal aneurysm - coiling