CASE REPORT
Neurosurgery
doi: 10.25005/2074-0581-2024-26-1-133-143
MICROSURGICAL TREATMENT OF DISTAL POSTERIOR INFERIOR CEREBELLAR ARTERY ANEURYSM DURING THE COLD PERIOD AFTER SPONTANEOUS INTRACRANIAL HEMORRHAGE: A CASE REPORT

N.O. RAKHIMOV1,2, KH.D. RAKHMONOV1,2, D.R. SANGINOV3, M.V. DAVLATOV1,2

1Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2National Medical Center of the Republic of Tajikistan «Shifobakhsh», Dushanbe, Republic of Tajikistan
3Department of Oncology and Diagnostic Imaging, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Aneurysms located on the distal portion of the posterior inferior cerebellar artery (PICA) are a rare disease that requires special treatment. Keeping the artery patent while excluding the aneurysm from the blood flow is essential during surgery. The patency ensures adequate blood circulation in the surrounding tissues and reduces the risk of ischemic complications. Therefore, carefully manipulating nearby anatomical structures is crucial to ensure successful surgery, minimize complications, and achieve optimal treatment results. This article describes a case of successful surgical intervention in a patient with a complex distal PICA aneurysm. The surgery was performed in the area of the anterior medullary segment using an extended retrosigmoid retrocondylar approach combined with C1 hemilaminectomy and monitoring the V3 segment of the vertebral artery. This approach has proven safe and effective, representing a promising alternative for the microsurgical treatment of PICA aneurysms, both in the acute and subacute stages of hemorrhage. The chosen surgical tactics helped prevent recurrent subarachnoid and intraventricular bleeding, as well as minimize the risk of ischemia, edema, and compression of the brain stem. These complications could lead to severe disability or even death.

Keywords: Posterior inferior cerebellar artery, distal aneurysm, intraventricular hemorrhage, microsurgical treatment, aneurysm clipping, clinical case.

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Authors' information:

Rakhimov Narzullo Odinaevich
Candidate of Medical Sciences, Assistant of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University; Neurosurgeon, National Medical Center of the Republic of Tajikistan «Shifobakhsh»
ORCID ID: 0000-0002-8471-1808
Е-mail: narzullorahimov91@gmail.com

Rakhmonov Khurshed Dzhamshedovich
Doctor of Medical Sciences, Associate Professor of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University; Principal Researcher, National Medical Center of the Republic of Tajikistan «Shifobakhsh»
ORCID ID: 0000-0002-6782-2979
Е-mail: doc-Rahmonov@mail.ru

Sanginov Dzhumaboy Rakhmatovich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Oncology and Diagnostic Imaging, Avicenna Tajik State Medical University
Researcher ID: AAH-2351-2021
ORCID ID: 0000-0002-4311-3094
SPIN: 3535-1025
Author ID: 1099938
E-mail: sanginov1952@gmail.com

Davlatov Manuchekhr Valievich
Candidate of Medical Sciences, Assistant of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-5504-19388
Е-mail: manuchehrd@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipmen

Conflicts of interest: No conflict

Address for correspondence:

Rakhimov Narzullo Odinaevich
Candidate of Medical Sciences, Assistant of the Department of Neurosurgery and Polytrauma, Avicenna Tajik State Medical University; Neurosurgeon, National Medical Center of the Republic of Tajikistan «Shifobakhsh»

734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31

Tel.: +992 (918) 470304

Е-mail: narzullorahimov91@gmail.com

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