Ruptured Total Intrameatal Anterior Inferior Cerebellar Artery Aneurysm

Kim, Hyung Cheol; Chang, In Bok; Lee, Ho Kook; Song, J. J.

doi:10.3340/jkns.2015.58.2.141

Cited by 8 publications

(15 citation statements)

References 9 publications

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“…[1][2][3][4][5][6][7][8] Intrameatal location for AICA aneurysms is also uncommon. 9 The AICA during its course has an abrupt turn at the internal auditory meatus and is in close relation to cranial nerve VII and VIII at that point. Common AICA-PICA trunk has similar course as that of AICA with the vessel dividing in rostral and caudal division.…”

Section: Discussionmentioning

confidence: 98%

Successful Endovascular Management of Intra-meatal Anterior Inferior Cerebellar Artery–Posterior Inferior Cerebellar Artery Variant Aneurysm

Bohra¹,

deSouza²,

Huded³

2018

J Clin Interv Radiol ISVIR

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Anterior inferior cerebellar artery–posterior inferior cerebellar artery (AICA-PICA) variant or common trunk is seen frequently in vertebral angiograms as PICA is found to be hypoplastic or absent in approximately 20 to 25% of patients. There have been very few case reports of aneurysm arising in AICA-PICA variant. Intrameatal AICA aneurysms are also rare, with no reports involving AICA-PICA variant till date. Neurosurgical approach and clipping have been proposed as first-line treatment option for intrameatal AICA aneurysms. The authors report a case of a young woman presenting with subarachnoid hemorrhage, found to have a right AICA-PICA variant aneurysm in intrameatal location. The patient underwent coiling with parent vessel occlusion after an unsuccessful attempt at surgical management of the same. She recovered without any postprocedure complication. This case report highlights the fact that endovascular approach can be used to manage distal AICA/AICA-PICA variant or intrameatal aneurysm with added advantage of avoiding the postprocedure complications associated with surgical management of the same.

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Section: Discussionmentioning

confidence: 98%

Successful Endovascular Management of Intra-meatal Anterior Inferior Cerebellar Artery–Posterior Inferior Cerebellar Artery Variant Aneurysm

Bohra¹,

deSouza²,

Huded³

2018

J Clin Interv Radiol ISVIR

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“…5 Small morphologic space makes surgical exposure critical with high complications. 1 Technical advances in endovascular procedures can make these treatment options as first-line treatment. Even though acute angulation of origin and tortuous anatomy can lead to difficult catheterization, we used balloon-assisted catheterization of the vessel for stable microcatheter position near the neck of the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

“…Incidence of aneurysms of the anterior inferior cerebellar artery (AICA) is approximately 0.1 to 0.5% among all intracranial aneurysms. 1 Recent review has reported only 21 cases of meatal segment AICA aneurysm. 2 Clinical presentation of these aneurysms varies from asymptomatic, isolated cranial nerve paralysis (VII and VIII) and rupture with acute subarachnoid hemorrhage (SAH).…”

Section: Introductionmentioning

confidence: 99%

Meatal Anterior Inferior Cerebellar Artery Aneurysm with AICA-PICA Complex: Endovascular Coiling and Parent Artery Preservation

Londhe

Gupta

Parthasarathy

et al. 2019

J Clin Interv Radiol ISVIR

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Secondary stroke prevention requires early initiation of antiplatelet; therefore, stroke mimics need to be ruled out particularly in circumstances when antiplatelet therapy can be of disastrous consequences. A 54-year-old female patient presented to the emergency department with symptoms of sudden-onset deviation of angle of mouth to the right side, left eye ptosis, and occipital headache for past 4-hour duration. Neurologic examination revealed right-sided gaze-dependent torsional nystagmus and left lower motor neuron facial weakness. An embolic posterior circulation stroke secondary to vertebral artery dissection was suspected. Diffusion-weighted imaging (DWI) did not show any acute infarcts, and careful review of susceptibility-weighted imaging (SWI) scans showed hemorrhage in the fourth ventricle. Subsequent digital subtraction angiography (DSA) was done, which showed left anterior inferior cerebellar artery (AICA) aneurysm involving its intrameatal segment with AICA-posterior inferior cerebellar artery (PICA) complex. Retrospective review of computed tomographic (CT) angiography images showed small aneurysm in the internal auditory meatus, which is difficult to discern secondary to adjacent bony structure and smaller size of the aneurysm. The patient underwent endovascular coiling of the aneurysm with preservation of the parent artery. Our experience concluded that these clinical features suggest remote subarachnoid hemorrhage secondary to the ruptured of AICA intrameatal segment aneurysm with left facial nerve paralysis and peripheral cochlear vestibular changes secondary to either compression (mechanical or pulsations of the aneurysm sac) or ischemia of vestibular apparatus. The neurointerventionist should consider the possibility of aneurysmal rupture, especially in cases of atypical location of hemorrhage and no signs of infarct on neuroimaging of posterior circulation stroke.

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“…Clinical data, angiograms in articles, management techniques, and patient outcomes were reviewed for 47 collected cases in 30 published reports. [1][2][3][4][5]7,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][31][32][33] AICA aneurysms associated with arteriovenous malformation (AVM) and Moyamoya disease were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Anterior inferior cerebellar artery (AICA) aneurysms are so rare that published experiences are limited to case reports and small patient series. 1–33 The description of AICA aneurysms in many of these reports is imprecise. 5,10–12,31–33 Several therapeutic options exist, encompassing microsurgical and endovascular techniques.…”

Section: Introductionmentioning

confidence: 99%

Anterior inferior cerebellar artery aneurysms: Segments and results of surgical and endovascular managements

et al. 2016

Interv Neuroradiol

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Background Anterior inferior cerebellar artery (AICA) aneurysms are rare and published clinical experience with these aneurysms is limited. Objective The objective of this article is to report angiographic characteristics and results associated with premeatal, meatal and postmeatal segments, surgical and endovascular therapies. Methods A literature review was performed through PubMed using “anterior inferior cerebellar artery aneurysm” through January 2016. Clinical data, angiograms, management techniques, and patient outcomes were reviewed for 47 collected cases in 30 previous reports. Results Of these aneurysms, 21 (44.7%) were associated with meatal segment, 10 (21.3%) were postmeatal and 16 (34.0%) were premeatal. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy (77.8%). Patient outcomes of meatal aneurysms presented with more neuropathies (51.7%) and cerebellar symptoms (14.3%) ( p = 0.049). Four cases of meatal aneurysm with preoperative cranial nerve deficits (two VII and two VIII) showed improvement after surgery. Endovascular treatment achieved outcomes similar to surgical treatment ( p = 0.327). Conclusions AICA aneurysms have a predilection for meatal segment. Patients with meatal aneurysms are more likely to present with subarachnoid hemorrhage and hearing loss and facial palsy. Patient outcomes of meatal aneurysms presented with more neuropathies and cerebellar symptoms. Endovascular treatment achieved outcomes similar to surgical treatment.

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Ruptured Total Intrameatal Anterior Inferior Cerebellar Artery Aneurysm

Cited by 8 publications

References 9 publications

Successful Endovascular Management of Intra-meatal Anterior Inferior Cerebellar Artery–Posterior Inferior Cerebellar Artery Variant Aneurysm

Successful Endovascular Management of Intra-meatal Anterior Inferior Cerebellar Artery–Posterior Inferior Cerebellar Artery Variant Aneurysm

Meatal Anterior Inferior Cerebellar Artery Aneurysm with AICA-PICA Complex: Endovascular Coiling and Parent Artery Preservation

Anterior inferior cerebellar artery aneurysms: Segments and results of surgical and endovascular managements

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