Fenestration of the posteroinferior cerebellar artery: Case report

OBJECTIVE AND IMPORTANCE: Fenestrations of cerebral arteries are rare, but very important to diagnose given their high association with saccular aneur ysms. We present the first reported case of a fenestration of the posteroin ferior cerebellar artery (PICA). CLINICAL PRESENTATION: A 62-year-old man who presented with a subarachnoid hemorrhage underwent repeated four-vessel cerebral angiography. An isolated right PICA abnormality consistent with a dissection or fenestration was re vealed. INTERVENTION: The patient underwent surgical exploration of his PICA, which confirmed a PICA fenestration without an associated saccular aneurysm. The fenestration was wrapped with cotton. CONCLUSION: Our case report illustrates the novel anatomic finding of a fen estration of the PICA. Knowledge of this entity would be helpful in the dif ferential diagnosis of a posterior fossa subarachnoid hemorrhage.