Intraventricular hemorrhage due to aneurysms of the distal posterior inferior cerebellar artery. Report of three cases

Three cases of ruptured aneurysm of the distal posterior inferior cerebellar artery (PICA) presenting with isolated intraventricular hematoma are reported. All of the aneurysms originated from the lateral medullary segment of the PICA and ruptured into the lateral recess of the fourth ventricle. The diagnosis of distal PICA aneurysm should be considered if isolated intraventricular hematoma is found without obvious parenchymal hemorrhage or subarachnoid blood in the basal cisterns. Complete vertebral arteriography is a requisite for the recognition of this condition. The outcome in patients with these aneurysms should be good if surgical repair is performed before rebleeding occurs.