Posterior inferior cerebellar artery aneurysm mimicking cervical myeloradiculopathy

Summary Aneurysms arising from the posterior inferior cerebellar artery (PICA) are uncommon, accounting for 0.5–3% of all intracranial aneurysms. Symptoms and signs usually include subarachnoid hemorrhage, neck pain, dizziness, and coma. We describe a patient who presented with cervical myeloradiculopathy (manifested by neck, shoulder, and arm pain) and an unsteady gait whose symptoms persisted after surgery on the cervical spine. A PICA aneurysm was diagnosed incidentally when we performed computed tomography (CT) of the brain and angiography after he fell into a coma. The patient was successfully treated with endovascular therapy. We emphasize that the symptoms of a PICA aneurysm may clinically mimic cervical myeloradiculopathy, and that PICA aneurysms may thus be overlooked.