Giant PICA Aneurysm

Kathleen A. Sorensen, MD; Georgianne M. Snowden, MD


Appl Radiol. 2007;36(11):66-70. 

In This Article


Giant aneurysms represent a minority of intracranial aneurysms, and those involving the PICA are especially rare. More commonly, they present secondary to the mass effects imparted, such as hydrocephalus, rather than to subarachnoid hemorrhage. The large size and heterogeneity of appearance would lead to a differential diagnosis that includes various tumors.

When encountering an intracranial mass, especially within the regions in which giant aneurysms commonly occur, it is important to include aneurysm in the differential diagnosis. Key characteristics that help to determine the etiology include a flow void or contrast enhancement within the mass or patent vessel leading into the mass, a multilaminated appearance, and artifacts that indicate that flowing blood is present, such as phase ghosting. Searching for these clues and providing a correct differential diagnosis could lead to a better overall outcome. In this case, although the PICA is an unusual location for giant aneurysms to occur, we believe a correct preoperative diagnosis could have been made based on the imaging features discussed above.


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