Pica artery surgery11/30/2023 ![]() 1), was located below the foramen magnum on the ascending part of the PICA. 1), and the pseudoaneurysm, extracranial but intradural (fig. ![]() The origin of the PICA was extradural at the level of the first cervical vertebra (fig. Cerebral angiography revealed a 6-mm-large dissecting aneurysm of the right PICA. Computed tomography (CT) scanning showed SAH predominating in the posterior fossa. Hospitalized few hours later, she did not present any neurological deficit but a very intense headache and mild neck stiffness. is a 40-year-old woman who experienced a sudden headache during a sexual relation, and then she lost consciousness for a while. The long-term clinical results depend mainly on the clinical status on admission. In the group of patients presenting SAH, endovascular treatment was safe and effective. The treatment depends on the existence of a hemorrhagic event. Conclusion: Clinical course and prognosis are variable in PICA dissections. A good recovery was achieved for 4 patients (modified Rankin Score 0) one patient who presented SAH and who was in bad clinical state on admission had a Glasgow Outcome Score of 3 and a modified Rankin Score of 4 three years later. ![]() We assessed the long-term results with the Glasgow Outcome Score and the modified Rankin Score. The angiographic and clinical follow-up lasted more than 3 years. Three patients presented acute hydrocephalus and were treated with surgical derivation. No ischemic complication and no rebleeding were observed after sacrifice of the PICA. The others presented subarachnoid hemorrhage (SAH) and were treated by embolization (endovascular sacrifice of the PICA). One patient presented ischemic manifestations he was treated with heparin. The diagnosis was carried out by cerebral angiography in all the cases: in 4, angiography showed focal stenosis with saccular or fusiform dilatation of the artery at the site of the dissection in 1 a double lumen aspect was described. No predisposing factor or traumatic cause was described in the other cases. Two patients presented symptoms after cervical manipulation. Methods and Results: From 1999 to 2003, five patients (40–71 years old) were hospitalized for PICA dissection. The aim of the study was to investigate the clinical manifestations, the neuroradiological aspects and the treatment of 5 cases collected in 5 years. Therefore, we decided on a conservative management with antiplatelet therapy and planned for a follow- up TFCA 2 weeks later.Background and Purpose: Spontaneous isolated posteroinferior cerebellar artery (PICA) dissection is very rare. Since 10 days had passed after dissection, a procedure-related risk from stent insertion or stent-assisted coil embolization was thought to be larger than a rupture risk. The follow-up TFCA 1 week later showed no change of stenosis of the right proximal PICA, but an additional finding of a pre-stenotic fusiform dilatation (3 x 4 mm) of the right proximal PICA was newly observed ( Fig. ![]() The origin of PICA was extracranial and dissection occurred at the lateral medullary segment of PICA, which was intradural. ![]() The transfemoral cerebral angiography (TFCA), performed 4 days after the onset of symptoms showed an abrupt segmental stenosis of the right proximal PICA, which is suggestive of dissection ( Fig. The magnetic resonance angiography (MRA) showed an abrupt luminal stenosis and subtle dilatation of the proximal segment of the right PICA, suggestive of possible dissection ( Fig. The brain magnetic resonance imaging (MRI) was performed 2 days after the onset of symptoms and showed an acute infarction in the right lateral medulla ( Fig. ![]()
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