Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare, accounting for less than 1% of all cerebral aneurysms. To our knowledge 34 flow-related cases including the present study have been reported in the literature.
Three patients harbouring four flow dependent aneurysms were referred to our institution. Two patients presented with subarachnoid hemorrhage, one presented with cerebellar manifestations. They were all treated by endovascular embolization of the aneurysm as well as the parent artery using liquid embolic material. Two cases were embolized using NBCA, Onyx was used in the third case.
No bleeding or rebleeding were encountered during the follow-up period which ranged from five to nine months.
One patient developed facial palsy, cerebellar symptoms and sensorineural hearing loss. The remaining two cases did not develop any post treatment neurological complications.
Endovascular management of flow-dependent AICA aneurysms by parent artery occlusion is feasible and efficient in terms of rebleeding prevention.
Post embolization neurological complications are unpredictable. This depends upon the adequacy of collaterals from other cerebellar arteries.
WeibelJFieldsWSCamposRJ. Aneurysms of the posterior cervicocranial circulation: clinical and angiographic considerations. J Neurosurg. 1967; 26: 223–234.
7.
MizushimaHKobayashiNYoshiharuS. Aneurysm of the distal anterior inferior cerebellar artery at the medial branch: a case report and review of the literature. Surg Neurol. 1999; 52: 137–142.
8.
RedekopGTerBruggeKMontaneraW. Arterial aneurysms associated with cerebral arteriovenous malformations: classification, incidence, and risk of hemorrhage. J Neurosurg. 1998; 89: 539–546.
9.
YamakawaHHattoriTTanigawaraT. Intracanalicular aneurysm at the meatal loop of the distal anterior inferior cerebellar artery: a case report and review of the literature. Surg Neurol. 2004; 61: 82–88.
10.
NishiSTakiWNakaharaIEmbolization of cerebral aneurysms with a liquid embolus, EVAL mixture: Report of three cases. Acta Neurochirur (Wein). 1996; 138: 294–300.
11.
AndaluzNPensakMLZuccarelloM. Multiple, peripheral aneurysms of the anterior inferior cerebellar artery. Acta Neurochir (Wien). 2005; 147: 419–422.
12.
BambakidisNCManjilaSDashtiS. Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature. Neurosurg Focus. 2009; 26: E6.
13.
NaderSPhirozTAlbertCL. The current role of microsurgery for posterior circulation aneurysms: a selective approach in the endovascular era. Neurosurgery. 2008; 62: 1236–1253.
14.
GacsGViñuelaFFoxAJ. Peripheral aneurysm of the cerebellar arteries. Review of 16 cases. J Neurosurg. 1983; 58: 63–68.
15.
KikuchiKKamisatoNSasanumaJ. Trigeminal neuralgia associated with posterior fossa arterio-venous malformation and aneurysm fed by the same artery. Case report. Neurol Med Chir (Tokyo). 1990; 30: 918–921.
16.
MenovskyTGrotenhuisAJBartelsRH. Aneurysm of the anterior inferior cerebellar artery (AICA) associated with high-flow lesion: report of two cases and review of the literature. J Clin Neurosci. 2002; 9: 207–211.
17.
AkyuzMTuncerR. Multiple anterior inferior cerebellar artery aneurysms associated with an arterio-venous malformation case report. Surg Neurol. 2005; 64: S106–S108.
18.
PelusoJPPvan RooijWJSluzewskiM. Distal aneurysms of cerebellar arteries: incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. Am J Neuroradiol. 2007; 28: 1573–1578.
19.
LubiczBLeclercXGauvritJY. Endovascular treatment of peripheral cerebellar artery aneurysms. Am J Neuroradiol. 2003; 24: 1208–1213.
20.
LeeSHKohSJBangJS. 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.2009; 46: 577–580.
21.
KanPStevensEAWarnerJ. Resolution of an anterior-inferior cerebellar artery feeding aneurysm with the treatment of a transverse-sigmoid dural fistula. Skull Base. 2007; 17: 205–210.
22.
SaitoANishinoASuzukiI. Subarachnoid hemorrhage caused by rupture of a distal anterior inferior cerebellar artery aneurysm-three case reports. Neurol Med Chir (Tokyo). 2008; 48: 506–511.
BinggeliRSSchrothGSteigerH-J. Distal aneurysm of the rostral duplicate anterior inferior cerebellar artery feeding an associated dural arteriovenous malformation: case report and review of the literature. J Clin Neurosci. 1998, 5: 237–244.
25.
MourierKLGelbertFAssoulineE. MRI in multiple vascular lesions: identification of the ruptured malformation. Acta Neurochir (Wien). 1991; 112: 83–87.
26.
DerutyRMottoleseCSoustielJF. Association of cerebral arteriovenous malformation and cerebral aneurysm. Diagnosis and management. Acta Neurochir (Wien). 1990; 107: 133–139.
27.
KaechDde TriboletNLasjauniasP. Anterior inferiorcerebellar artery aneurysm, carotid bifurcation aneurysm, and dural arterio-venous malformation of the tentorium in the same patient. Neurosurgery. 1987; 21: 575–582.
28.
LeeSJKohJSRyuCW. Ruptured intrameatal aneurysm of the anterior inferior cerebellar artery accompanying an arteriovenous malformation: a case report. Cerebellum. 2012; Jan 5 [Epub ahead of print].
29.
LiXZhangDZhaoJ. Anterior inferior cerebellar artery aneurysms: six cases and a review of the literature. Neurosurg Rev.2012; 35: 111–119.
30.
SuhSHKimDJKimDI. Management of anterior inferior cerebellar artery aneurysms: endovascular treatment and clinical outcome. Am J Neuroradiol. 2011; 32: 159–164.
31.
VincentelliFCarusoGLicastroG. Association between an aneurysm of the anterior inferior cerebral artery and an arteriovenous malformation fed by the same artery. J Neurosurg Sci.1998; 42: 41–45.
32.
De AguiarGBVeigaJCEFeresFJO. Association between a ruptured distal anterior inferior cerebral artery aneurysm and arteriovenous malformation fed by the same artery. Arq Neuropsiquiatr. 2011; 69: 989–990.
