Utility of transcranial color-coded duplex sonography in diagnosis and monitoring of PICA aneurysm in subarachnoid hemorrhage.

This case describes the successful use of transcranial color-coded duplex sonography (TCCD) to diagnose a posterior circulation aneurysm in a patient with subarachnoid hemorrhage. A 33-year-old, was admitted to the ICU after a brain CT scan showed peritroncal subarachnoid hemorrhage. TCCD revealed a rounded image with color Doppler near the P1 portion of the right posterior cerebral artery, which was later confirmed to be a 4 mm aneurysm at the right posterior inferior cerebellar artery (PICA). The aneurysm was treated with coil exclusion and TCCD confirmed its disappearance post-treatment. While TCCD has limitations, including its inability to detect small aneurysms, it is a noninvasive diagnostic tool that provides real-time visualization of the brain and allows for follow-up evaluations. This case demonstrates the potential usefulness of TCCD in diagnosing cerebral aneurysms in patients with subarachnoid hemorrhage and for follow-up evaluations post-treatment.