MR Angiography of Peripheral Posterior Inferior Cerebellar Artery Aneurysms

Abstract
A small subset of posterior inferior cerebellar artery (PICA) aneurysms arise distal to the vertebral artery origin of the PICA. We present two such cases seen on conventional angiography and MR angiography (MRA). The findings in two patients are presented. In one the aneurysm presented with subarachnoid hemorrhage. The second was found incidentally but later ruptured. There was good agreement between the appearance of the aneurysms on MRA and conventional angiography. Awareness of the possibility of peripheral PICA aneurysms and their features is important. The positioning of the volume of excitation for MRA may have to be adjusted to include a very low PICA caudal loop.

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