Subarachnoid Hemorrhage Caused by Rupture of a Distal Anterior Inferior Cerebellar Artery Aneurysm  -Three Case Reports-

Saitô, Atsushi; Nishino, Akiko; Suzuki, Ichirô; Suzuki, Hiroyasu; Utsunomiya, Akihiro; Suzuki, Shinsuke; Uenohara, Hiroshi; Sakurai, Yasuhisa

doi:10.2176/nmc.48.506

Cited by 13 publications

(8 citation statements)

References 16 publications

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“…ANOVA, analysis of variance; CI, confidence interval; SAA, subarcuate artery. circulation seem to contribute to the development of distal AICA aneurysms, 61,62 as well as high-flow situations, as vascularized tumors, 62,63 arteriovenous fistula, 64 and malformations. 65,66 Also, a case of ruptured aneurysm of a SAA feeding a dural arteriovenous fistula was reported.…”

Section: Discussionmentioning

confidence: 99%

A Classification for the Anterior Inferior Cerebellar Artery—Subarcuate Artery Complex Based on the Embryological Development

Rasmussen

Plou

Campero³

et al. 2019

J Neurol Surg B Skull Base

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Objective To hierarchize the anterior inferior cerebellar artery (AICA)–subarcuate artery (SAA) complex's variations in the surgical field. Background The AICA's “subarcuate loop” (SL) presents multiple variations, closely related to the SAA. AICA-SAA complex's variations may represent major issues in cerebellopontine angle (CPA) surgery. As the spectrum of configurations is originated during the development, a systematized classification was proposed based on the interaction between the petrosal bone and the AICA in the embryonic period. Methods The variations were defined as follow: Grade 0: free, purely cisternal AICA, unidentifiable or absent SAA; Grade 1: purely cisternal AICA, loose SL, SAA > 3 mm; Grade 2: AICA near the subarcuate fossa, pronounced SL, SAA <3 mm; Grade 3: “duralized” AICA, unidentifiable SAA, or included in the petromastoid canal (PMC); and Grade 4: intraosseous AICA, unidentifiable SAA, or included in the PMC. The classification was applied to a series of patients assessed by magnetic resonance constructive interference in steady state sequence. Surgical examples were also provided. Results Eighty-four patients were evaluated, including 161 CPA. The proportions found in the gradation remained within the range of previous publications (Grade 0: 42.2%; Grade 1: 11.2%; Grade 2: 35.4%; Grade 3: 10.6%; and Grade 4: 0.6%). Moreover, the degrees of the classification were related to the complexity of the anatomical relationships and, therefore, to the difficulty of the maneuvers required to overcome them. Conclusion The proposed AICA-SAA complex classification allowed to distinguish and objectify pre- and intraoperatively the spectrum of variations, to thoroughly plan the required actions and instrumentation.

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Section: Discussionmentioning

confidence: 99%

A Classification for the Anterior Inferior Cerebellar Artery—Subarcuate Artery Complex Based on the Embryological Development

Rasmussen

Plou

Campero³

et al. 2019

J Neurol Surg B Skull Base

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“…Distal AICA aneurysms often present with SAH,3–5 7 9 10 12 14–16 18 24–29 31 but can also present with other symptoms of mass effect such as headache,13 19 vomiting,19 dizziness,11 ataxia,9 19 vertigo,9 hearing loss,4 10 13 19 facial paresis,4 13 trigeminal neuralgia,6 and seizures 8 19. Axial imaging with CT angiography, MRI, or MR angiography should be obtained, but occasionally the aneurysm can be occult10 or mistaken for other cerebellopontine angle or intracanalicular masses 11 13.…”

Section: Discussionmentioning

confidence: 99%

“…The most commonly used overall treatment is surgical clipping with AICA preservation 3–6 8–10 12 18 21 22 27. Other surgical approaches include surgical trapping3 9 13 18 and occipital to AICA bypass 29. The most commonly used endovascular treatment is PVO with coils 7 9 14 16 26 28.…”

Section: Discussionmentioning

confidence: 99%

Republished: Ruptured distal AICA pseudoaneurysm presenting years after vestibular schwannoma resection and radiation

McNeill

Mocco

Berenstein

et al. 2015

J NeuroIntervent Surg

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SUMMARYDistal anterior inferior cerebellar artery (AICA) pseudoaneurysms are very rare lesions. Although cases have been previously reported, only a few have been reported as a result of vestibular schwannoma (VS) radiation, none have been reported as a result of VS resection, and only one has been reported as treated with parent vessel occlusion (PVO) with n-butyl cyanoacrylate (nBCA). We report a case of a 65-year-old man with a history of right-sided VS surgery and radiation who presented years later with a ruptured pseudoaneurysm of the distal right AICA and was treated with endovascular PVO using nBCA. The aneurysm was completely obliterated and the patient had no worsening of symptoms or neurological exam. The case illustrates a very rare complication of VS surgery and radiation as well as an effective treatment for distal AICA aneurysms. BACKGROUND

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“…6,12,14,18,25 Trapping of the middle or distal segment of the AICA after passing the internal auditory canal in 4 patients did not result in permanent neurological deficits. 3,17,22,25 …”

Section: Discussionmentioning

confidence: 99%

Intrameatal thrombosed anterior inferior cerebellar artery aneurysm mimicking a vestibular schwannoma

Päsler¹,

Baldauf²,

Runge

et al. 2011

JNS

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Aneurysms of the anterior inferior cerebellar artery (AICA) are a rare entity. Purely intrameatal aneurysms are even rarer. The authors report an intrameatal thrombosed AICA aneurysm mimicking a vestibular schwannoma that was treated by resection and end-to-end anastomosis. This 22-year-old man presented with acute hearing loss, vertigo, and moderate facial palsy. Magnetic resonance imaging showed an atypical intrameatal lesion with dilation of the internal auditory canal. Microsurgical inspection via a retrosigmoid approach and drilling of the posterior wall of the internal auditory canal revealed a thrombosed AICA aneurysm. The aneurysm was excised, and an end-to-end suture was performed to restore AICA continuity. Intraoperative indocyanine green videoangiography as well as postoperative digital substraction angiography showed a good revascularization. Intrameatal AICA aneurysms may present with symptoms similar to vestibular schwannomas. End-to-end reanastomosis after aneurysm resection is a treatment option when clipping is impossible.

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Subarachnoid Hemorrhage Caused by Rupture of a Distal Anterior Inferior Cerebellar Artery Aneurysm -Three Case Reports-

Cited by 13 publications

References 16 publications

A Classification for the Anterior Inferior Cerebellar Artery—Subarcuate Artery Complex Based on the Embryological Development

A Classification for the Anterior Inferior Cerebellar Artery—Subarcuate Artery Complex Based on the Embryological Development

Republished: Ruptured distal AICA pseudoaneurysm presenting years after vestibular schwannoma resection and radiation

Intrameatal thrombosed anterior inferior cerebellar artery aneurysm mimicking a vestibular schwannoma

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