A 54-year-old lady presented with the history of two episodes of subarachnoid haemorrhage, the last one occurring one month prior to presentation. She was evaluated at a peripheral hospital with a CT angiogram which revealed a right Pcom aneurysm and subsequently referred to our centre for management. Clinical examination did not reveal any neurological deficit. Cerebral angiography revealed a large bilobed right posterior communicating artery aneurysm measuring 10.2mm x 12.4mm with a neck width of 5mm.
The posterior communicating artery originated from the neck of the aneurysm and supplied the posterior cerebral artery territory. In addition there was a small unruptured 4mm x 5mm clinoidal segment aneurysm with a narrow neck. On vertebral artery injection, there was complete non-filling of the basilar bifurcation with aplasia of bilateral P1 segment of posterior cerebral arteries. Due…
