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Figure 1: A 54-year old female patient presented with acute subarachnoid hemorrhage (SAH). Selective injection of the left vertebral artery (VA) showing a dissecting aneurysm involving the intradural segment of left VA proximal to the posterior inferior cerebellar artery (PICA) origin (a). Contralateral VA is dominant (d). Road map in working projection (b) shows the microcatheter tip within the aneurysm. Coil embolization of the aneurysm and adjoining parent artery (internal trapping) was done achieving complete aneurysmal occlusion (c). Contralateral VA is dominant enough to take care of the posterior circulation as well as to facilitate retrograde flow in the distal left V4 segment allowing a retrograde blood circulation into the left PICA (e). Diagrammatic representation of the same (f) and, the dense mass of the coils within the aneurysmal sac (g)

Figure 1: A 54-year old female patient presented with acute subarachnoid hemorrhage (SAH). Selective injection of the left vertebral artery (VA) showing a dissecting aneurysm involving the intradural segment of left VA proximal to the posterior inferior cerebellar artery (PICA) origin (a). Contralateral VA is dominant (d). Road map in working projection (b) shows the microcatheter tip within the aneurysm. Coil embolization of the aneurysm and adjoining parent artery (internal trapping) was done achieving complete aneurysmal occlusion (c). Contralateral VA is dominant enough to take care of the posterior circulation as well as to facilitate retrograde flow in the distal left V4 segment allowing a retrograde blood circulation into the left PICA (e). Diagrammatic representation of the same (f) and, the dense mass of the coils within the aneurysmal sac (g)