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Fig 2. An 80-year-old woman (patient 10; Table) experienced severe vertigo with sudden onset. CT examination revealed a small right-sided intracerebral hematoma in cerebellar vermis, hemorrhage in the fourth ventricle, and prepontine cistern. Subsequent DSA revealed a dissecting aneurysm of the right PICA and a saccular aneurysm of the basilar tip (A). A superselective right PICA injection demonstrated an irregular, fusiform PICA aneurysm located in the cortical segment (B). Parent artery occlusion of the dissected cortical segment of PICA and coil embolization of the basilar tip aneurysm were performed in the same session. In control angiogram after the treatment, both aneurysms are occluded (C). Posttreatment CT showed PICA infarct, and the patient had temporary worsening of vertigo, but in 6 months of follow-up she recovered without any symptoms.
