{
  "abstract": "A 58-year-old woman presented with sudden-onset severe headache and decreased consciousness. Computed tomography revealed posterior fossa–predominant subarachnoid hemorrhage. Digital subtraction angiography demonstrated a rete-like collateral network of the left posterior inferior cerebellar artery, an extremely rare vascular anomaly in which the posterior inferior cerebellar artery trunk divides into a plexiform network of small dysplastic channels before reconstituting into distal branches. A 1.5-mm aneurysmal lesion was identified on one channel of this network by superselective angiography and was considered the bleeding source; given its small size and the fragile dysplastic substrate, a pseudoaneurysm could not be excluded. After emergent hematoma evacuation, the aneurysm-bearing channel was selectively occluded with 25% n-butyl cyanoacrylate (0.2 mL). Post-embolization angiography confirmed exclusion of the lesion with preserved distal posterior inferior cerebellar artery perfusion through the remaining channels. Diffusion-weighted imaging at 48 hours showed no new ischemic lesions in the posterior inferior cerebellar artery perfusion territory. The patient was discharged with a modified Rankin Scale score of 2, which improved to 1 at 7 months. A rete-like collateral network of the posterior inferior cerebellar artery is exceedingly rare. Although a ruptured pseudoaneurysm on a hypoplastic and plexiform posterior inferior cerebellar artery has been reported, a ruptured aneurysmal lesion arising from a focal rete-like collateral network of an otherwise normal posterior inferior cerebellar artery, treated by selective channel occlusion, has not previously been described. The multi-channel architecture of this anomaly may permit selective occlusion of an aneurysm-bearing channel while maintaining distal perfusion; however, the potential risk of brainstem perforator infarction must be carefully considered, and further experience is needed before this strategy can be generalized.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Akira SAITO"
    },
    {
      "affs": [
        0
      ],
      "name": "Tomoko IKEMOTO"
    },
    {
      "affs": [
        0
      ],
      "name": "Shunya HANAKITA"
    },
    {
      "affs": [
        0
      ],
      "name": "Satoshi IIHOSHI"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7acb7x45gew7d.bib",
  "cited_by": 0,
  "doi": "10.2176/jns-nmc.2026-0226",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13730790/",
  "id": "7acb7x45gew7d",
  "issns": [
    "2188-4226"
  ],
  "landing_url": "https://doi.org/10.2176/jns-nmc.2026-0226",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Case Report"
    ],
    [
      "openalex",
      "2728|Intracranial Aneurysms: Treatment and Complications"
    ]
  ],
  "openalex": "W7221526677",
  "pdf_url": "https://www.jstage.jst.go.jp/article/nmccrj/13/0/13_2026-0226/_pdf",
  "pmcid": "PMC13730790",
  "pmid": "42979664",
  "published": "2026-10-13",
  "publisher": "Japan Neurosurgical Society",
  "ris": "https://research.draconitic.com/paper/7acb7x45gew7d.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:16Z",
      "native_id": "PMC13730790",
      "source": "pmc",
      "url": "https://doi.org/10.2176/jns-nmc.2026-0226"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Intracranial Aneurysms: Treatment and Complications",
      "subfield": "neurology"
    }
  ],
  "title": "Selective n-Butyl Cyanoacrylate Embolization of a Ruptured Aneurysmal Lesion Arising from a Rete-like Collateral Network of the Posterior Inferior Cerebellar Artery",
  "title_text": "Selective n-Butyl Cyanoacrylate Embolization of a Ruptured Aneurysmal Lesion Arising from a Rete-like Collateral Network of the Posterior Inferior Cerebellar Artery",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:23:16Z",
  "url": "https://research.draconitic.com/paper/7acb7x45gew7d",
  "venue": "NMC Case Report Journal",
  "versions": []
}