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Neurosurgical Review

, Volume 35, Issue 1, pp 111–119 | Cite as

Anterior inferior cerebellar artery aneurysms: six cases and a review of the literature

  • Xin Li
  • Dong Zhang
  • Jizong ZhaoEmail author
Original Article

Abstract

Aneurysms of the anterior inferior cerebellar artery are rare. Six cases of anterior inferior cerebellar artery (AICA) aneurysms treated at one center are presented. The six cases of AICA aneurysms were surgically treated. The clinical features, surgical process, complications, and follow-up are demonstrated. Six patients with six AICA aneurysms were presented including one AVM accompanied aneurysm and one giant aneurysm. Five aneurysms had ruptured, one was unruptured. Five patients presented with subarachnoid hemorrhage (SAH) including two with intraventricular hemorrhaging and one with an intraparenchymal hematoma. One aneurysm was proximal, two were distal, and three were meatal. All cases were treated surgically. Retrosigmoid and far-lateral craniectomy were included. Navigation was accomplished through intraoperative ultrasound and fluorescent angiography. Resection of the aneurysm after clipping was significant. The most common postoperative deficit involved the cranial nerves in four patients. Follow-up was available for all patients for a mean of 68 months. SAH is the most common presentation. The relationship between the aneurysms and the meatus is an important factor for neurological dysfunction. 3D-CTA and MRA may be considered as diagnostic adjuncts. Several special surgical techniques used in our cases are worth noting. Endovascular therapy for AICA aneurysms is in the process of development and should be reserved for special cases.

Keywords

Aneurysm Anterior inferior cerebellar artery (AICA) Arteriovenous malformation Giant aneurysm Subarachnoid hemorrhage Endovascular coiling 

Notes

References

  1. 1.
    Duvoisin RC, Yahr MD (1965) Posterior fossa aneurysms. Neurology 15:231–241PubMedGoogle Scholar
  2. 2.
    Investigators International Study of Unruptured Intracranial Aneurysms (1998) Unruptured intracranial aneurysms—risk of rupture and risks of surgical intervention. N Engl J Med 339:1725–1733CrossRefGoogle Scholar
  3. 3.
    McDonald C, Korb M (1939) Intracranial aneurysms. Arch Neurol Psychiatry 42:298–328Google Scholar
  4. 4.
    Weibel J, Fields WS, Campos RJ (1967) Aneurysms of the posterior cervicocranial circulation: clinical and angiographic considerations. J Neurosurg 26:223–234PubMedCrossRefGoogle Scholar
  5. 5.
    Kamano S, Kirino T, Mizuno S (1986) Intrameatal aneurysm. Neurochirurgia (Stuttg) 29:28–30Google Scholar
  6. 6.
    Locksley HB (1966) Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations: based on 6368 cases in the cooperative study. J Neurosurg 25:219–239PubMedCrossRefGoogle Scholar
  7. 7.
    Locksley HB, Sahs AL, Knowler L (1966) Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section II. General survey of cases in the central registry and characteristics of the sample population. J Neurosurg 24:922–932PubMedCrossRefGoogle Scholar
  8. 8.
    Péter B, Sipos L, Vajda J (1996) Aneurysm of the internal auditory artery: our experience and review of the literature. Acta Neurochir (Wien) 138:1157–1162CrossRefGoogle Scholar
  9. 9.
    Chen ZP (1990) Anterior inferior cerebellar artery aneurysm: report of two cases. Zhonghua Wai Ke Za Zhi 28:490–511 [in Chinese]PubMedGoogle Scholar
  10. 10.
    Crockard HA, Koksel T, Watkin N (1991) Transoral transclival clipping of anterior inferior cerebellar artery aneurysm using new rotating applier: technical note. J Neurosurg 75:483–485PubMedCrossRefGoogle Scholar
  11. 11.
    Gruber A, Killer M, Bavinzski G, Richling B (1999) Clinical and angiographic results of endosaccular coiling treatment of giant and very large intracranial aneurysms: a 7-year, single-center experience. Neurosurgery 45:793–803PubMedCrossRefGoogle Scholar
  12. 12.
    Ildan F, Gocer AI, Bagdatoglu H, Uzuneyupoglu Z, Tuna M, Cetinalp E (1996) Isolated trigeminal neuralgia secondary to distal anterior inferior cerebellar artery aneurysm. Neurosurg Rev 19:43–46PubMedCrossRefGoogle Scholar
  13. 13.
    Kyoshima K, Matsuda M, Handa J (1995) Cerebral aneurysm of the distal anterior inferior cerebellar artery: case report. Nippon Geka Hokan 64:139–145PubMedGoogle Scholar
  14. 14.
    Lawton MT, Daspit CP, Spetzler RF (1997) Technical aspects and recent trends in the management of large and giant midbasilar artery aneurysms. Neurosurgery 41:513–521PubMedGoogle Scholar
  15. 15.
    Mizushima H, Kobayashi N, Yoshiharu S et al (1999) Aneurysm of the distal anterior inferior cerebellar artery at the medial branch: a case report and review of the literature. Surg Neurol 52:137–142PubMedCrossRefGoogle Scholar
  16. 16.
    Nader S, Phiroz T, Albert CL, Michael TL (2008) The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular ear. Neurosurgery 62:1236–1253CrossRefGoogle Scholar
  17. 17.
    Nishi S, Taki W, Nakahara I et al (1996) Embolization of cerebral aneurysms with a liquid embolus, EVAL mixture: report of three cases. Acta Neurochir (Wien) 138:294–300CrossRefGoogle Scholar
  18. 18.
    Oana K, Murakami T, Beppu T, Yamaura A, Kanaya H (1991) Aneurysm of the distal anterior inferior cerebellar artery unrelated to the cerebellopontine angle: case report. Neurosurgery 28:899–903PubMedCrossRefGoogle Scholar
  19. 19.
    Saito A, Ezura M, Takahashi A, Yoshimoto T (2000) An arterial dissection of the distal anterior inferior cerebellar artery treated by endovascular therapy. No Shinkei Geka 28:269–274 [in Japanese]PubMedGoogle Scholar
  20. 20.
    Spallone A, De Santis S, Giuffre R (1995) Peripheral aneurysms of the anterior inferior cerebellar artery: case report and review of the literature. Br J Neurosurg 9:537–541PubMedCrossRefGoogle Scholar
  21. 21.
    Suzuki K, Meguro K, Wadw M, Fujita K, Nose T (1999) Embolization of a ruptured aneurysm of the distal anterior inferior cerebellar artery: case report and review of the literature. Surg Neurol 51:509–512PubMedCrossRefGoogle Scholar
  22. 22.
    Vincentelli F, Caruso G, Licastro G, Rabehanta P (1998) Association between an aneurysm of the anterior inferior cerebral artery and an arteriovenous malformation fed by the same artery. J Neurosurg Sci 42:41–45PubMedGoogle Scholar
  23. 23.
    Woischneck D, Hussein S (1991) The anterior inferior cerebellar artery (AICA): clinical and radiological significance. Neurosurg Rev 14:293–295PubMedCrossRefGoogle Scholar
  24. 24.
    Drake CG, Peerless SJ, Hernesniemi JA (1995) Surgery of vertebrobasilar aneurysms: London, Ontario experience on 1767 patients. Springer, New YorkGoogle Scholar
  25. 25.
    Gonzalez LF, Alexander MJ, McDougall CG, Spetzler RF (2004) Anteroinferior cerebellar artery aneurysms: surgical approaches and outcomes—a review of 34 cases. Neurosurgery 5:1025–1035CrossRefGoogle Scholar
  26. 26.
    Rhoton AL (2000) The posterior cranial fossa: microsurgical anatomy and surgical approaches. Neurosurgery 47(Suppl):29–68CrossRefGoogle Scholar
  27. 27.
    Yamakawa H, Hattori T, Tanigawara T, Sahashi Y, Ohkuma A (2004) Intracanalicular aneurysm at the meatal loop of the distal anterior inferior cerebellar artery: a case report and review of the literature. Surg Neurol 1:82–88, discussion 88CrossRefGoogle Scholar
  28. 28.
    Cronqvist S, Troupp H (1996) Intracranial arteriovenous malformation and arterial aneurysm on the same patient. Acta Neurol Scand 42:307–316CrossRefGoogle Scholar
  29. 29.
    Rohde V, Spangenberg P, Mayfrank L, Reinges M, Gilsbach JM, Coenen VA (2005) Advanced neuronavigation in skull base tumors and vascular lesions. Minim Invasive Neurosurg 50:742–749Google Scholar
  30. 30.
    Akyüz M, Tuncer R (2005) Multiple anterior inferior cerebellar artery aneurysms associated with an arteriovenous malformation: case report. Surg Neurol 64(Suppl 2):S106–S108PubMedCrossRefGoogle Scholar
  31. 31.
    Drake CG, Friedman AH, Peerless SJ (1986) Posterior fossa arteriovenous posterior fossa arteriovenous. J Neurosurg 64:1–10PubMedCrossRefGoogle Scholar
  32. 32.
    Guzman R, Grady MS (1999) An intracranial aneurysm on the feeding artery of a cerebellar hemangioblastoma: case report. J Neurosurg 91:136–138PubMedCrossRefGoogle Scholar
  33. 33.
    Kikuchi K, Kamisato N, Sasanuma J, Watanabe K, Kowada M (1990) Trigeminal neuralgia associated with posterior fossa arteriovenous malformation and aneurysm fed by the same artery. Case report. Neurol Med Chir (Tokyo) 30:918–921CrossRefGoogle Scholar
  34. 34.
    Menovsky T, André GJ, Bartels RH (2002) Aneurysm of the anterior inferior cerebellar artery associated with high-flow lesion: report of two cases and review of literature. J Clin Neurosci 9:207–211PubMedCrossRefGoogle Scholar
  35. 35.
    Thompson RC, Steinberg GK, Levy RP, Marks MP (1998) The management of patients with arteriovenous malformation and associated intracranial aneurysms. Neurosurgery 43:202–211PubMedCrossRefGoogle Scholar
  36. 36.
    Lee SH, Koh JS, Bang JS, Kim GK (2009) A case of ruptured peripheral aneurysm of the anterior inferior cerebellar artery associated with an arteriovenous malformation a less invasive image guided transcortical approach. J Korean Neurosurg Soc 46:577–580PubMedCrossRefGoogle Scholar
  37. 37.
    Figueiredo EG, Gomes MQ, Brito-Neto RV, Paiva WS, Teixeira MJ (2008) A giant partially thrombosed AICA aneurysm. Arq Neuropsiquiatr 3A:566–568CrossRefGoogle Scholar
  38. 38.
    Pritz MB (1993) Aneurysms of the anterior inferior cerebellar artery. Acta Neurochir (Wien) 120:12–19CrossRefGoogle Scholar
  39. 39.
    Dalley RW, Robertson WD, Nugent RA, Durity FA (1986) Computed tomography of anterior inferior cerebellar artery aneurysm mimicking an acoustic neuroma. J Comput Assist Tomogr 10:881–894PubMedCrossRefGoogle Scholar
  40. 40.
    Zager EL, Shaver EG, Hurst RW, Flamm ES (2002) Distal anterior inferior cerebellar artery aneurysms. Report of four cases. J Neurosurg 3:692–696Google Scholar
  41. 41.
    Iwanaga S, Shrier DA, Okawara SH, Numaguchi Y (1999) Value of CT angiography in the evaluation of a peripheral anterior inferior cerebellar artery aneurysm: case report. Clin Imaging 23:77–80PubMedCrossRefGoogle Scholar
  42. 42.
    Bambakidis NC, Manjila S, Dashti S, Tarr R, Megerian CA (2009) Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature. Neurosurg Focus 26(E6):1–8Google Scholar
  43. 43.
    Nishimoto A, Fujimoto S, Tsuchimoto S et al (1983) Anterior inferior cerebellar artery aneurysm. Report of three cases. J Neurosurg 59:697–702PubMedCrossRefGoogle Scholar
  44. 44.
    Andaluz N, Pensak ML, Zuccarello M (2005) Multiple, peripheral aneurysms of the anterior inferior cerebellar artery. Acta Neurochir (Wien) 4:419–422, discussion 422CrossRefGoogle Scholar
  45. 45.
    Peluso JP, Van Rooij WJ, Sluzewski M, Beute GN (2007) Distal aneurysms of cerebellar arteries: incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. Am J Neuroradiol 28:1573–1578PubMedCrossRefGoogle Scholar
  46. 46.
    Ishii D, Takechi A, Shinagawa K, Sogabe T (2010) Endovascular treatment for ruptured anterior inferior cerebellar artery aneurysm. Neurol Med Chir 50:396–399CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Neurosurgery, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina

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