BACKGROUND: @entity439 located on the distal posterior @entity5487 (PICA) are rare, and their underlying clinical features and surgical management are poorly understood. We report our series of 16 @entity1 with 18 @entity5487 . METHOD: All @entity1 with @entity5487 were treated between March 1996 and August 2004. We excluded all PICA @entity439 that involved the vertebral artery. @entity1 were analysed in the light of their clinical profiles, radiological studies, intraoperative findings and outcomes. All @entity1 underwent non-enhanced and contrast enhanced CT scans followed by 4-vessel cerebral angiography on admission. The hemorrhagic patterns on initial CT scans were assessed using the Fisher Grading Score. The outcomes were documented using the Glasgow Outcome Scale at time of discharge and at three or twelve months follow-up. FINDINGS: The series included 6 @entity1 and 10 @entity1 . Massive @entity548 was found in 13 @entity1 with proven CT @entity510 , one @entity1 revealed @entity510 without intraventricular components, one presented with only intraventricular blood in the occipital horns and 3 @entity439 were found incidentally without presence of blood. Fourteen @entity439 were saccular and four were fusiform. Nine cases were associated with another @entity75 . A lateral transcondylar or a median suboccipital approach was used to secure the @entity439 in 15 @entity1 , either by direct clipping (14 lesions) or vessel sacrifice (3 lesions). One @entity439 was treated by an endovascular approach. At long-term follow up, an excellent or good outcome was achieved in 75% of cases. One @entity1 died due to pre-existing @entity532 . CONCLUSIONS: Most of our cases of @entity5487 presented with haematocephalus. These were frequently associated with another @entity455 and 22% were fusiform or multilobulated. These specific features require special management strategies entailing an appropriate surgical approach to the @entity439 , clipping method, haematoma removal, ventricular drainage and when suitable choice of endovascular interventions.

XXXX : clinical characteristics and surgical management.

@entity1 :: ('9606', 'Species') :: ['women', 'Patients', 'patients', 'patient', 'men'] @entity455 :: ('MESH:D014652', 'Disease') :: ['vascular abnormality'] @entity548 :: ('MESH:D006470', 'Disease') :: ['intraventricular haemorrhage'] @entity510 :: ('MESH:D013345', 'Disease') :: ['subarachnoid haemorrhage', 'SAH'] @entity75 :: ('MESH:D001927', 'Disease') :: ['cerebrovascular lesion'] @entity532 :: ('MESH:D003925', 'Disease') :: ['cardiopulmonary complications'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms', 'aneurysm', 'Aneurysms'] @entity5487 :: ('MESH:D014854', 'Disease') :: ['distal PICA aneurysms', 'ruptured distal PICA aneurysms', 'inferior cerebellar artery']
@entity5487 :: (MESH:D014854,Disease) :: ['Distal posterior inferior cerebellar artery aneurysms']
