# Large Posterior Communicating Artery Aneurysm Presenting as Hemiparesis: A Case Report

## TL;DR

A rare case of a large PCOM artery aneurysm causing hemiparesis is reported, highlighting the importance of timely diagnosis and endovascular treatment.

## Contribution

This case report emphasizes hemiparesis as an atypical presentation of PCOM aneurysms and the effectiveness of balloon remodeling coiling.

## Key findings

- A 42-year-old male with hypertension presented with hemiparesis due to a large PCOM aneurysm.
- Endovascular coiling via balloon remodeling successfully treated the aneurysm with postoperative recovery.
- The case underscores the need for clinical vigilance in atypical presentations of PCOM aneurysms.

## Abstract

Posterior communicating artery (PCOM) aneurysms, even though rare, can lead to severe neurological deficits alongside life-threatening conditions, demanding rapid detection and intervention. We report a case of a 42-year-old male patient, known hypertensive, presenting with symptoms of headache, dizziness, and right-sided weakness. Imaging showed a saccular aneurysm in the left middle cerebral artery (MCA) alongside an acute-subacute subarachnoid hemorrhage. A subsequent computed tomography (CT) angiography established a large PCOM aneurysm. Above all, the aneurysm caused hemiparesis, a comparatively rare manifestation. Treated effectively through a balloon remodeling coiling technique, the patient recovered postoperatively. This case report also highlights the significance of timely recognition and the usefulness of endovascular coiling in treating PCOM aneurysms. Precisely, those patients presenting with atypical symptoms like hemiparesis lay stress on the need for strong clinical vigilance and further research to improve management strategies intended for these rare but critical conditions.