Table 1 Literature review of similar cases compared to our case
Authors | Imaging | Management | Follow-up |
|---|---|---|---|
Khayat et al. [20] | Partially thrombosed giant right PICA aneurysm -Cerebellar AVM with a nidus < 3 cm supplied by the right PICA | Endovascular treatment of aneurysm Treatment of AVM deferred | No complications 9-month MRI follow-up: decrease in the size of the aneurysm |
David Case et al. [9] | Right distal PICA telovelotonsillar segment Aneurysm | Parent vessel sacrifice with Onyx, partial AVM embolization with Onyx | Death |
Aneurysm of distal right PICA in the telovelotonsillar segment + AVM of the superior cerebellar vermis | Parent vessel sacrifice with onyx, AVM treatment deferred | Death | |
A small distal left PICA aneurysm in the left telovelotonsillar segment and small AVM in the vermis | Parent vessel sacrifice with NBCA and Onyx, complete AVM embolization with NBCA | No complications | |
Right PICA aneurysm with vermian AVM | Parent vessel sacrifice with NBCA, AVM treatment with gamma knife | No complications | |
Left PICA aneurysm in the telovelotonsillar segment with small AVM in the superior aspect of the vermis | ·Parent vessel sacrifice with NBCA, AVM treatment deferred | No complications | |
Yasuda et al. [21] | Right telovelotonsillar segment and cerebellar AVM feed by the left superior cerebellar artery | Complete resection of the cerebellar AVM and clipping of the distal PICA aneurysm | No complications |
Al-Jehani et al. [22] | Inferior vermian AVM with a flow-related aneurysm at the left PICA origin | Excision of AVM 24 h after glue embolization of AVM | 5 years after AVM resection: regrowth of the aneurysm to 10.2 mm (which was coiled) |
Nonaka et al. [23] | Two saccular aneurysms on the peripheral left PICA formed an arteriovenous shunt adjacent to the transverse sinus | Embolization of the proximal aneurysm and resection of the arteriovenous shunt lying superficially in the cerebellar hemisphere | Delayed perioperative ischemic deficit |
Musluman et al. [24] | Left occipital lobe hematoma—Grade II AVM is supplied by the distal branch of the left middle cerebral artery and has drainage into the superior sagittal sinus Saccular aneurysm on the left PICA | Drainage of the hematoma + Left parietooccipital craniotomy + Left lateral sub-occipital craniectomy + Clipping of PICA aneurysm | No complications |
Our case | PFC hematoma, mass effect on the fourth ventricle—Upper vermian AVM feed by the right PICA and 2 flow-related aneurysm | Surgical exclusion of the 2 aneurysms on the distal segment of the PICA AVM referred for SRS | No complications at 6 months follow-up |