What is PICA aneurysm?
Summary. Aneurysms arising from the posterior inferior cerebellar artery (PICA) are uncommon, accounting for 0.5–3% of all intracranial aneurysms. Symptoms and signs usually include subarachnoid hemorrhage, neck pain, dizziness, and coma.
Where is a PICA aneurysm?
The PICA is the greatest of the branches of the vertebral artery, and is the causative vessel for aneurysms in the posterior cranial fossa (including dissecting aneurysms), which cause cerebral infarction and cranial nerve compression in many cases.
What is a PCA aneurysm?
Aneurysms of the posterior cerebral artery (PCA) represent approximately 1% of all intracranial aneurysms (1–4). The surgical approach and dissection of the PCA is technically challenging owing to the complexity of its perforating branches and their intimate relationship with the cranial nerves and upper brain stem.
What causes a PICA stroke?
PICA may arise from the vertebral artery (the usual case), or as a separate branch of the basilar artery. Because of the far more common origin from the vertebral artery, most “PICA” syndrome strokes actually are due to vertebral artery occlusion (Kim 2003).
What happens when the right posterior communicating artery is blocked?
This blockage keeps blood from reaching its destination in the brain, resulting in a loss of function in the affected region. Strokes can happen when a blood clot gets lodged in an artery, becomes blocked from disease, or if a blood vessel bleeds.
Why is neck clipping important for pica aneurysms?
For all PICA aneurysms which arise proximally, surgical neck clipping of the aneurysm is crucial. This is because the process of getting a hold of the aneurysm could mean considerable compromise, resulting in puncturing the critical arteries in the brainstem.
Which is the best treatment for a pica aneurysm?
Snipping the neck of an aneurysm via surgical clipping remains the best bet for all aneurysms of the peripheral regions of the PICA. For all PICA aneurysms which arise proximally, surgical neck clipping of the aneurysm is crucial.
What kind of aneurysm is posterior inferior cerebellar artery ( PICA )?
Posterior inferior cerebellar artery (PICA) aneurysms are associated with multiple anatomical variations of the parent vessel. Complexities in their surgical clipping relate to narrow corridors limited by brain-stem, petrous-occipital bones, and multiple neurovascular structures occupying the cerebellomedullary and cerebellopontine cisterns. Aims:
How is a distal pica aneurysm exposed?
Distal PICA aneurysms are exposed via a midline suboccipital craniotomy. The patient is positioned in the park-bench position. The goal is to position the head in order to create the most ergonomic working angle directly along the axis of the VA.