A Case of Ruptured Distal Posterior Inferior Cerebellar Artery Aneurysm Treated with Intra-aneurysmal Coil Embolization

<p><b>Objective:</b> We report a case wherein coil embolization with an intention to preserve the hemispheric branches was performed to treat a ruptured saccular aneurysm in the distal posterior inferior cerebellar artery (PICA) during the acute period. The considerations that led to the selection of the endovascular treatment are discussed.</p><p><b>Case Presentation:</b> The patient was an 87-year-old woman who presented with subarachnoid hemorrhage. After considering the patient's age and the severity of her condition, intra-aneurysmal coil embolization was performed to treat a saccular aneurysm in the left telovelotonsillar segment. The parent artery was preserved, and no postoperative complications were noted.</p><p><b>Conclusion:</b> Either parent artery embolization or intra-aneurysmal embolization should be selected as the endoscopic treatment methodology for de novo saccular aneurysms located in the PICA, except for those in the vertebral artery bifurcation area. The treatment selection should be based on careful evaluation of the aneurysm size, parent artery diameter, and aneurysm site.</p>