• Sung Ho Lee, Jong Un Moon, Seok Keun Choi, Man Kyu Choi, Juhie Lee, and Ji-Youn Sung.
• Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea. Electronic address: nslsh@khu.ac.kr.
• World Neurosurg. 2016 Aug 1; 92: 580.e11-580.e15.

BackgroundTraumatic pseudoaneurysm of the distal posterior inferior cerebellar artery (PICA) is extremely rare. We report our experience of a case of pseudoaneurysm that developed on the PICA after blunt trauma to the head.Case DescriptionA 55-year-old woman was transferred to our emergency department presenting with a semicomatose mental status after falling to the floor from a standing position. Computed tomography showed a small intracerebral hemorrhage and subarachnoid hemorrhage in the cerebellum. Cerebral angiography revealed no causative lesion. After 3 days, the woman was nearly mentally alert. One month later, follow-up angiography showed a small, newly developed saccular aneurysm at the distal PICA. The patient underwent surgical treatment via a midline suboccipital approach. The aneurysm was surrounded by a subacute-stage subdural hematoma and protruded into the cortex. The aneurysm was coagulated and resected. On pathologic examination, pseudoaneurysm was diagnosed without infectious inflammation. No surgery-related morbidity occurred.ConclusionsGiven that development of traumatic pseudoaneurysm usually is delayed, follow-up radiologic examination is required, especially for patients with severe blunt trauma.Copyright © 2016 Elsevier Inc. All rights reserved.

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