Aneurysm of the internal auditory artery: Our experience and review of the literature

Banczerowski, Péter; Sípos, László; Vajda, J.

doi:10.1007/bf01809744

Cited by 24 publications

(17 citation statements)

References 27 publications

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“…12,17) Unruptured distal AICA aneurysms are associated with hearing disturbance, facial nerve paresis, tinnitus, and vertigo. 3,15,17) In our case, we explored other etiologies such as ischemia and cerebellopontine angle tumor, but did not suspect unruptured aneurysm and thus did not perform conventional angiography or 3-D CT angiography.…”

Section: Discussionmentioning

confidence: 97%

Distal Anterior Inferior Cerebellar Artery Aneurysm Occult on Magnetic Resonance Angiography One Month Prior to Rupture-Case Report-

Kondoh

Kurihara

Kohmura

2003

Neurol. Med. Chir.(Tokyo)

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A 77-year-old man suffered subarachnoid hemorrhage due to a ruptured aneurysm of the distal anterior inferior cerebellar artery (AICA). He had a history of hearing disturbance in the left ear for more than 3 years. Computed tomography on three separate occasions had found no abnormalities. One month before the hemorrhage, he came to our outpatient service complaining of vertigo. Magnetic resonance (MR) imaging and MR angiography detected no abnormality. Conventional angiography demonstrated an aneurysm of 8 mm diameter in the distal AICA region after the hemorrhage. Filling and wash out of the aneurysm sac by contrast medium was markedly delayed, which suggested that MR imaging had failed to detect the flow void because of the slow blood flow in the dome. The aneurysm was clipped successfully. He was discharged with mild dysarthria on the 33rd postoperative day. MR angiography has limitations in detecting unruptured aneurysms and there is certainly a high risk group of false negatives, including aneurysms located in the distal region of the main trunk.

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Section: Discussionmentioning

confidence: 97%

Distal Anterior Inferior Cerebellar Artery Aneurysm Occult on Magnetic Resonance Angiography One Month Prior to Rupture-Case Report-

Kondoh

Kurihara

Kohmura

2003

Neurol. Med. Chir.(Tokyo)

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“…São poucos os casos descritos na literatura desde 1948 (total de 61 casos), em duas revisões da literatura até a presente data 2,4 (Tabela 1). Em conclusão, os aneurismas de AICA, apesar de sua frequência pouco representativa no universo dos aneurismas cerebrais, menos de 1% destes, devem sempre ser considerados no diagnóstico diferencial da síndrome do ângulo ponto cerebelar.…”

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“…Os aneurismas cerebrais da circulação posterior têm sido relatados com frequência que varia de 3,3 a 29,5% de todos os aneurismas, com média em torno de 15% [1][2][3][4] . Destes, os mais comuns são os localizados: na bifurcação e tronco da artéria basilar; na artéria cerebelar postero inferior (PICA) e sua junção com a artéria vertebral; na artéria cerebelar superior e sua junção com a artéria basilar; e, finalmente, os aneurismas localizados na artéria cerebelar ântero-inferior (AICA).…”

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“…A maioria dos casos de aneurisma da AICA possui localização distal, na região do ângulo ponto cerebelar e apenas 3 casos dos descritos na literatura possuíam localização no segmento medial da AICA em território da artéria auditiva interna (IAA). Até 2002, existem duas revisões da literatura 2,4 com o total de 61 casos relatados. A maioria destes aneurismas, excluindo os da junção da artéria basilar com a AICA, causam hemorragia subaracnóidea (HSA).…”

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Aneurisma da artéria cerebelar ântero-inferior: relato de caso

Adorno¹,

Andrade

2002

Arq. Neuro-Psiquiatr.

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RESUMO -Os aneurismas intracranianos do sistema vértebro-basilar representam cerca de 5 a 10% de todos os aneurismas cerebrais. Os aneurismas da artéria cerebelar ântero-inferior (AICA) são considerados raros, podendo causar síndrome do ângulo ponto cerebelar, com ou sem hemorragia subaracnóidea. Desde 1948, foram descritos poucos casos na literatura. Apresentamos o caso de uma paciente, de 33 anos, na qual, após investigação de quadro de hemorragia subaracnóidea, diagnosticou-se aneurisma sacular da AICA esquerda. Foi submetida a clipagem do aneurisma, com ótimo resultado pós operatório.PALAVRAS-CHAVE: aneurisma cerebral, artéria cerebelar ântero inferior, hemorragia subaracnóidea. Aneurysm of the anterior inferior cerebellar artery: case reportABSTRACT -The intracranial aneurysms of the posterior circulation have been reported between 5 and 10% of all cerebral aneurysms and the aneurysms of the anterior inferior cerebellar artery (AICA) are considered rare, can cause cerebello pontine angle (CPA) syndrome with or without subarachnoid hemorrhage. Since 1948 few cases were described in the literature. We report on a 33 year-old female patient with subarachnoid hemorrhage due to sacular aneurysm of the left AICA. She was submitted to clipage of the aneurysm without complications.KEY WORDS: cerebral aneurysms, anterior inferior cerebellar artery, subarachnoid hemorrhage.

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“…By 1989, only 33 cases had been reported in the literature [1][2][3][4] . Subsequently, numerous case reports and small series of AICA aneurysms have been reported 1,2,[5][6][7][8][9][10][11][12][13][14][15] . Giant aneurysms of proximal portion of AICA are even more uncommon, being difficult to estimate their actual incidence.…”

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A giant partially thrombosed aica aneurysm

Figueiredo

Gomes

Neto

et al. 2008

Arq. Neuro-Psiquiatr.

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Aneurysms of the anteroinferior cerebellar artery (AICA) are rare, comprising far less than 1% of all intracranial aneurysms. By 1989, only 33 cases had been reported in the literature [1][2][3][4] . Subsequently, numerous case reports and small series of AICA aneurysms have been reported 1,2,[5][6][7][8][9][10][11][12][13][14][15] . Giant aneurysms of proximal portion of AICA are even more uncommon, being difficult to estimate their actual incidence. These aneurysms constitute formidable surgical challenge and a judicious preoperative planning is mandatory since surgical nuances often determined the final outcome.We present a case of giant partially thrombosed AICA aneurysm and discuss operative nuances required to minimize the morbidity associated with such surgically challenging lesions. CASEA 62 years old female presented sudden headache. At emergency room, neurological examination revealed meningismus. TC scan disclosed subarachnoid hemorrhage. Angiographic evaluation diagnosed three aneurysms at left middle cerebral artery, posterior communicating artery and a small left AICA aneurysm (Fig 1). Anterior circulation aneurysms were treated trough a left pterional approach. Postoperative course was uneventful. After two years, she returned complaining of trigeminal disestesias. Neurological examination displayed mild left facial paresis and right hemiparesis. TC scan revealed image suggestive of a thrombosed aneurysm compressing brainstem. This finding was confirmed by angiotomography and digital angiography that demonstrated giant thrombosed AICA aneurysm (Fig 2). Occlusion balloon test was carried out and patient stood asymptomatic after thirty minutes of occlusion.A right transcocclear approach was performed and the facial nerve was skeletomized and mobilized. Vertebral arteries, basilar trunk and AICA were identified and dissected (Fig 3). Temporary clips were applied proximal and distally, aneurysm sac was incised. Thrombus was removed in order to deflate the aneurysm. Two fenestrated clips were applied to the neck to preserve AI-CA (Fig 4). Two temporary clipping (thirty minutes each) were necessary to performing these maneuvers. Abdominal fat pad was harvested and used to pack the petrosal space and a catheter for lumbar drainage was inserted.Definitive deficits were deafness in the right side and right facial paresis. Postoperative angiogram disclosed adequate surgical result (Fig 5). The patient has agreed with this case publication. DISCUSSIONThe surgical exposure of AICA aneurysms is difficult due to distance of the lesions from the cranial base and their close relationship to the brainstem and lower cranial

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Aneurysm of the internal auditory artery: Our experience and review of the literature

Cited by 24 publications

References 27 publications

Distal Anterior Inferior Cerebellar Artery Aneurysm Occult on Magnetic Resonance Angiography One Month Prior to Rupture-Case Report-

Distal Anterior Inferior Cerebellar Artery Aneurysm Occult on Magnetic Resonance Angiography One Month Prior to Rupture-Case Report-

Aneurisma da artéria cerebelar ântero-inferior: relato de caso

A giant partially thrombosed aica aneurysm

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