Posterior Circulation Aneurysms Management

Posterior circulation aneurysms account for 3.8–15% of intracranial aneurysms, among which the aneurysms in intracranial segments of the vertebral artery and apex of the basilar artery are common, while the rare sites are posterior cerebral artery, posterior inferior cerebellar artery, and anterior inferior cerebellar artery [1]. Previous studies have shown that aneurysms in the posterior circulation have a greater tendency to rupture than those in the anterior circulation. The related risks of aneurysm rupture are site, shape, blood flow, and flow rate [2, 3]. Additionally, there is a higher tendency for posterior circulation aneurysms to be giant or fusiform with attendant mass effects, ischemic effects, and hydrocephalus, which make their management complicate. Accidental cases may have no clinical symptoms. Large unruptured aneurysms may be treated due to the local occupying effect and corresponding clinical symptoms. Patients with ruptured posterior circulation aneurysms visit the hospital due to bleeding-related symptoms. The rupture risk of posterior circulation aneurysms is 50%, the annual rupture incidence is about 10%, and the mortality rate within 2 years is as high as 60%. Therefore, treatment should be given as soon as possible after the diagnosis of the posterior circulation aneurysms [4].