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Bilateral mirror posterior inferior cerebellar artery aneurysms: diagnostic caveat on catheter angiography
  1. Walter S Lesley
  1. Correspondence to Dr W S Lesley, Departments of Radiology, Surgery and Neurosurgery, Division of Neuroradiology, Section of NeuroInterventional Surgery, Texas A&M University Health Sciences Center College of Medicine/Scott and White Clinic, Suite 2X, 2401 South 31st Street, Temple, TX 76508, USA; wlesley{at}


Only three definitive cases of bilateral mirror proximal posterior inferior cerebellar artery (PICA) aneurysms have ever been reported. A fourth example is presented where each PICA aneurysm remained angiographically occult on contralateral vertebral artery angiography despite retrograde filling of the parent vessel PICA. Implications for clinical practice are discussed.

  • Artery
  • Brain
  • Aneurysm
  • Coil

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.