• 61-year-old man who presented with severe occipital headache, nausea and vomiting, and loss of consciousness.
  
  

Imaging

 
CT of his brain showed subarachnoid hemorrhage with extension to his fourth ventricle.

CTA (Computer Tomographic Angiography) of the patient’s brain showed a posterior inferior cerebellar artery aneurysm (PICA).

Surgical Procedure

• The patient was treated using a far lateral skull base approach with surgical clipping of the aneurysm.
  
  

Post-Op Imaging

Postoperative angiogram showed complete removal of the aneurysm.

• Despite having a significant vasospasm 10 days after the hemorrhage, the patient was discharged from the hospital with mild lower cranial nerve palsy.