Acta Neurochirurgica

, Volume 161, Issue 6, pp 1183–1189 | Cite as

Serpentine aneurysm of the posterior cerebral artery treated by internal maxillary artery bypass followed by parent artery occlusion: a case report and literature review

  • Jie Zhang
  • Xiang’en ShiEmail author
  • Fangjun Liu
  • Yuming Sun
  • Hai Qian
  • Zhongqing Zhou
Case Report - Vascular Neurosurgery - Aneurysm
Part of the following topical collections:
  1. Vascular Neurosurgery – Aneurysm


Serpentine aneurysms of the posterior cerebral artery (PCA) treated by the internal maxillary artery (IMA) bypass are rare. Here, the authors report the case of a 34-year-old male patient who presented with a half-year history of gradual severe headache and right-sided limb monoparesis and paresthesia lasting for 1 week. Preoperative angiograms showed a serpentine aneurysm in the left distal PCA, which was treated with internal maxillary artery-radial artery-posterior cerebral artery (IMA-RA-PCA) bypass followed by parent artery occlusion (PAO). The postoperative course was uneventful; radiological images revealed that the aneurysm disappeared, and there was good graft patency and excellent perfusion of the distal PCA territories. To the authors’ knowledge, this is the first and only case of distal PCA serpentine aneurysm to be treated by IMA-RA-PCA bypass followed by proximal PAO. These findings suggest that IMA bypass surgery is a good and feasible treatment option for serpentine aneurysms of the PCA that can preserve the parent artery. Moreover, the anatomic segments of the PCA and different treatment options available for PCA serpentine aneurysms are also discussed in this study.


Serpentine aneurysm Posterior cerebral artery Internal maxillary artery Bypass 



Beijing Municipal Science and Technology Commission provided financial support in the form of Natural Science Foundation of Beijing Municipality funding (grant no. 7161005 to Xiang’en Shi) and Capital Foundation of Medical Development (grant no. Z161100000516019 to Xiang’en Shi). The sponsor had no role in the design or conduct of this research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Beijing Municipal Science and Technology Commission) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Patient consent

The patient has consented to the submission of the case report for submission to the journal.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurosurgery, Affiliated Fuxing HospitalCapital Medical UniversityBeijingPeople’s Republic of China
  2. 2.Department of Neurosurgery, Beijing Sanbo Brain HospitalCapital Medical UniversityBeijingChina

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