Characteristics and endovascular treatment of aneurysms of posterior cerebral artery

Background: Aneurysms of the posterior cerebral artery (PCA) are a distinct rarity and present with some peculiar morphologic features and specific clinical findings. These aneurysms can be managed endovascularly with good results. Objective: To evaluate the clinical features and endovascular management of PCA aneurysms. Material and Methods: Between 2000 and 2008, we treated 24 patients (14 male and 10 female; mean age: 36 years) with PCA aneurysms. Clinical presentations, radiologic images, and endovascular management were reviewed. Results: There were 11 saccular aneurysms, including 4 giant or large aneurysms, and 13 dissecting aneurysms, including 11 giant or large aneurysms. Of the 24 patients, 13 presented with hemorrhage and 6 with neurologic deficits. Five patients presented with headaches without any neurologic deficits. Parent vessel occlusion was performed in 12 patients, selective coil embolization was performed in 11 patients, and 1 patient conservatively. Eighteen patients had a good recovery, 5 had a moderate disability (one with 1 visual deficit after the treatment) related to hemorrhage, vasospasm, or infarction before aneurysm trapping, and 1 patient died because of rebleeding. The conservatively treated patient made a good recovery. Conclusion: PCA aneurysms have specific clinical characteristics compared with aneurysms located elsewhere. Endovascular technique can achieve good outcomes despite the aneurysmal site and size.