Introduction: True aneurysms of the occipital artery (OA) are, with only a few cases reported in
the literature. The exact pathophysiology is unknown, and the presentation depends
on the aneurysm location and rupture status. We present a case of a ruptured intracranial
aneurysm arising from a branch of the occipital artery.
Objective: To describe a rare case of intracranial aneurysm arising from the retromastoid branch
of the occipital artery.
Method: The patient is a 36-year-old male who presented with altered mental status after
being assaulted. On exam, he was intubated with a Glasgow coma scale of 9. Imaging
revealed a subdural hematoma of the posterior fossa and the cervical spine. He underwent
suboccipital craniectomy with C1–5 laminectomy with the evacuation of the subdural
hematoma ([Fig. 1]). Postoperative cerebral angiography revealed an intracranial aneurysm arising from
the retro-mastoid branch of the occipital artery ([Fig. 2]). The aneurysm was embolized using platinum coils along with the parent vessel.
Result: The patient tolerated the procedure well. Also, the patient underwent craniocervical
instrumented fusion to stabilize the craniovertebral junction. Eventually, the patient
was discharged home with a modified Rankin scale of 2. No outpatient follow-up data
available as the patient lost to follow-up.
Conclusion: Intracranial aneurysms of the occipital artery are extremely rare. Their etiology
remains elusive, with some association with increased flow demand. No clear consensus
concerning the management of these aneurysms. Both endovascular and or open surgical
techniques can be used depending on the aneurysm characteristics, patient condition,
and others.[1]-[3]
Fig. 1
Fig. 2
