Endovascular Approach of a Proximal Anterior Inferior Cerebellar Artery Aneurysm: Case Report

Abstract

Anterior inferior cerebellar artery (AICA) aneurysms are extremely rare, accounting for only 0.75% of all intracranial aneurysms. The average age of patients suffering from those aneurysms found in the literature was 44 years, with no significant difference between the sexes. These aneurysms can manifest clinically through expansive symptoms in cerebellopontine angle or through signs and symptoms of subarachnoid hemorrhage, such as nausea, vomiting, headache, nystagmus and paresis. The gold standard exam for diagnosis is cerebral angiography. The treatment of these lesions is controversial. The main difficulty of the surgical treatment of these aneurysms is the location of the AICA, which lies close to critical neurovascular structures. In this article, we describe a proximal AICA aneurysm embolization without occlusion of the parent artery, with excellent results in the postoperative period. Palavras-chave► artéria cerebelar anterior inferior ► procedimentos endovasculares ► aneurisma intracraniano ResumoOs aneurismas da artéria cerebelar anterior inferior (AICA) são extremamente raros, representando apenas 0,75% de todos os aneurismas intracranianos. A idade média de acometimento encontrada na literatura é de 44 anos, não havendo diferença significativa entre os sexos. A etiologia do aneurisma da AICA é controversa, porém, acreditase haver semelhanças com aneurismas em geral. Clinicamente, esses aneurismas podem manifestar sintomas expansivos no ângulo ponto-cerebelar, ou sinais e sintomas de hemorragia subaracnóidea (HSA), como náuseas, vômitos, cefaleia, nistagmo. O exame padrão-ouro para o diagnóstico é a angiografia cerebral. A maior controvérsia dos aneurismas da AICA é o tratamento. A principal dificuldade no tratamento cirúrgico desses aneurismas é a localização da AICA, perto de estruturas neurovasculares críticas. Neste artigo, descrevemos a embolização de um aneurisma proximal da AICA sem oclusão da artéria portadora, com excelentes resultados no pós-operatório.

Parent Artery Occlusion against Dissecting Aneurysm Involving the Proximal Anterior Inferior Cerebellar Artery: Case Report and Literature Review

“…Few reports suggested that coil embolization and parent artery occlusion (PAO) would be valuable treatment options against dissecting AICA aneurysms. 3 - 6) However, the records of incidence and therapeutics of the dissecting AICA aneurysms in literature are rare. 7 - 9) …”

“…Few reports suggested that coil embolization and parent artery occlusion (PAO) would be valuable treatment options against dissecting AICA aneurysms. [3][4][5][6] However, the records of incidence and therapeutics of the dissecting AICA aneurysms in literature are rare. [7][8][9] In this article, we report a case of dissecting AICA aneurysm treated with PAO, and discuss the therapeutics and literature review of this pathology.…”