The Neuroradiology Journal 21: 261-265, 2008
www. centauro. it
Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm A Case Report and Review of the Literature
XIANLI LV, YOUXIANG LI, AIHUA LIU, JINGBO ZHANG, ZHONGXUE WU Beijing Neurosurgical Institute; Beijing, China Beijing Tiantan Hospital, Capital Medical University; Beijing, China
Key words: aneurysm, anterior inferior cerebellar artery, coil embolization
SUMMARY – Most cases of aneurysms associated with the distal portion of the anterior inferior cerebellar artery resulted in a hearing disturbance from the surgical procedure, although aneurysms far from the auditory artery had no deficit from trapping. We describe a patient with an aneurysm at the distal segment of the anterior inferior cerebellar artery (AICA) treated endovascularly by parent artery occlusion.
Introduction Aneurysms of the distal anterior inferior cerebellar artery (AICA) are rare and almost all of them have been treated surgically, by clipping or trapping 1,7,8,12,15-19,21,25-27,31-33,35-37,39. We describe a patient with an aneurysm arising from the meatal loop of the AICA, which was cured by coil embolization of the parent artery. Case Report A 34-year-old woman experienced a sudden onset of severe headache and vomiting. Computed tomographic scanning revealed a right cerebellar and subarachnoid hemorrhage. Cerebral digital subtraction angiography (DSA) showed a saccular aneurysm distal to the meatal loop of the right AICA. General anesthesia was used, 5000 U of heparin was administered at the start of the procedure, followed by 1000 U every hour until completion. A catheter was placed in the common femoral artery and then passed up into the aortic arch, and selective catheterization of the right vertebral artery was performed. A microcatheter (Echelon 10, M.T.I) was passed in a coaxial fashion through the introducer
catheter followed by selective catheterization of the right AICA. The tip of the catheter was placed proximal to the aneurysm because the excessive tortuous vessel did not allow access to the aneurysm with the catheter, and coils were placed just proximal to the aneurysm. The artery was occluded with two 30 mm and two ×10 mm hydrocoils (Microvention). Angiography was performed after coil placement to confirm occlusion of the parent vessel and aneurysm. Anticoagulation treatment was given after the procedure. The patient demonstrated mild vertigo and diplopia while staring at something for three days. The patient was discharged normally on day five. Discussion Aneurysms of the distal anterior inferior cerebellar artery (AICA) are very rare 3,4,14,20,25,28,31,40. The most common clinical symptoms are subarachnoid hemorrhage (SAH) and dysfunction of the facial and acoustic nerves 10,12,18,29,33,37. Therefore SAH associated with symptoms of the facial and/or acoustic nerve suggests the rupture of a distal AICA aneurysm. Table 1 summarizes the treatment of AICA aneurysms 1,2,5,6-9,12,15-21,23-27,29,31-37,39 . 261
Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm
Xianli Lv
Table 1 Summary of reported cases. Author
Year
Presentation
Kaech D et Al 16
1987
SAH, cerebellar hemorrhage
Surgical clipping
No deficit
Kiya K et Al
1989
SAH, CNVII, VIII deficits
Surgical clipping
Improved
Russegger L et Al 28
1990
SAH
No
Died
Zager EL
1991
SAH, CNV deficit
Surgical excision
CNV deficit
Oana K et Al 26
1991
Intraventricular hemorrhage
Surgical clipping
No deficit
Kamiya K et Al 17
1994
SAH, CNVIII deficit
Surgical trapping
CNVIII deficit
SAH
Surgical clipping
No deficit
1994
SAH, CNVII, VIII deficits
Surgical clipping
CNVIII deficit
1995
SAH, CNVII, VIII deficits
Surgical trapping
No deficit
Yokoyama S et Al 36
1995
SAH, CNVII deficit
Surgical trapping
CNVIII deficit
Kyoshima K et Al
1995
SAH
Surgical clipping
No deficit
Vincentelli F et Al 34
1998
SAH, CPA syndrome
Surgical clipping
No deficit
Cloft HJ et Al
1999
SAH
PAO (coil)
No deficit
Suzuki K et Al 33
1999
SAH
PAO (coil)
No deficit
Mizushima H et Al 25
1999
Epilepsy
Surgical clipping
No deficit
Ebara M et Al 8
1999
SAH
Surgical clipping
No deficit
Eckard et Al 9
2000
SAH, no clinical deficit
PAO (coil)
CNVIII deficit
Saito Retal et Al 30
2001
SAH
Surgical clipping
CNVIII deficit
SAH
Surgical clipping
No deficit
SAH
PAO (coil)
CNVIII deficit
Cerebellar syndrome
Surgical wrapping
Enlargement
Cerebellar hemorrhage
Surgical clipping
No deficit
18
38
Honda Y et Al 12 Spallone A et Al
32
21
6
Menovsky T et Al 24
2002
Therapy
Clinical deficit after therapy
Matsuyama T et Al 23
2002
SAH
Endosaccular coiling
No deficit
Adorno JO et Al
2002
SAH
Surgical clipping
No deficit
Maekawa M et Al 22
2003
Intraventricular hemorrhage
PAO (coil)
No deficit
Jayaraman MV et Al 15
2003
SAH
Surgical trapping
No deficit
Kondoh T et Al 19
2003
SAH
Surgical clipping
Mild dysarthria
2003
Acute dizziness
Surgical excision
No deficit
2004
SAH
Surgical clipping
CNVII, VIII deficits
Sarkar A et Al 31
2004
CNVII, VIII deficits
Surgical trapping
No deficit
Akyuz M et Al
2005
SAH
No
Dizziness
2006
SAH
PAO (coil)
No deficit
2006
SAH
Endosaccular coiling
No deficit
2007
SAH, cerebellar hemorrhage
PAO (coil)
No deficit
1
DiMaio S et Al 7 Yamakawa H et Al
2
Choi CH et Al 5 Kusaka N et Al Present case
262
20
35
www. centauro. it
The Neuroradiology Journal 21: 261-265, 2008
Figure 1 CT scan demonstrating the intracerebellar hemorrhage.
The most common sign caused by surgical occlusion is VIIIth cranial nerve disturbance 31,37 . Clearly, AICA obstruction does not necessarily cause severe neurological deficits 10,14. Anastomoses must have been present between the AICA and the posterior inferior cerebellar artery in these patients 38. However, such anastomoses could be damaged by surgical manipulations. We think that endovascular treatment may be safer, simpler and more effective. An excellent outcome was obtained without significant complications in our patient with peripheral AICA aneurysm treated by parent vessel occlusion, unlike most cases previously reported in which a surgical procedure was used. It is our belief that as compared with balloons coils are more likely to create a permanent occlusion if the vessel is well packed 22. Balloons may deflate, resulting in recanalization of the aneurysm. Moreover, in our case, a balloon would have been more difficult or even impossible to navigate into position in the peripheral branches we occluded. Compared with glue, coils can be placed precisely, with less chance of distal embolization, which would block possible collateral branches.
Test injection with Amytal was not perform in our case because we believe that Amytal testing is overly predictive of deficits owing to its deep penetration into all of the peripheral vessels 6,9,13. When the vessel is actually occluded, collaterals may partially by-pass the occlusion, which accounts for the discrepancy. Fortunately, this patient experienced only transient mild vertigo and diplopia while staring at something. The patient has been through rehabilitation and has gradually improved. Endovascular obliteration is also a reasonable option, although the possibility of retrograde thrombosis of the AICA is a concern. Conclusion For aneurysms distal to branches coursing to the brainstem, parent artery occlusion is a viable option that does not require by-pass. Intravascular treatment of distal AICA aneurysms remote from the auditory artery may be safer and simpler than surgical treatment. This report summarized previous cases and discuss the treatment of aneurysms of the AICA through a review of the literature. 263
Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm
A
B
C
D
Xianli Lv
Figure 2 A) 3D reconstruction of the right vertebral injection showing an aneurysm in the distal portion of the AICA. Right vertebral angiogram, anteroposterior (B) and lateral (C) views after the procedure showing complete occlusion of the parent artery and the aneurysm. D) Skull X-ray film showing coil deposition.
References 1 Adorno JQ, de Andrade GC: Aneurysm of the anterior inferior cerebellar artery: case report. Arq Neuropsiquiatr 60: 1019-1024, 2002. 2 Akyuz M, Tuncer R: Multiple anterior inferior cerebellar artery aneurysms associated with an arteriovenous malformation: case report. Surg Neurol 64: 106-108, 2005.
264
3 Andreou A, Ioannidis I, Mitsos A: Endovascular treatment of peripheral intracranial aneurysms. Am J Neuroradiol 28: 355-361, 2007. 4 Andaluz N, Pensak ML, Zuccarello M: Multiple, peripheral aneurysm of the anterior inferior cerebellar artery. Acta Neurochir 147: 419-422, 2005. 5 Choi CH, Cho WH, Choi BK et Al: Rerupture following
www. centauro. it
6
7 8
9
10
11 12 13 14
15
16
17 18 19
20
21 22 23
24 25
endovascular treatment for dissecting aneurysm of distal anterior inferior cerebellar artery with parent artery preservation: retreatment by parent artery occlusion with Guglielmi detachable coils. Acta Neurochir 148: 363-366, 2006. Cloft HJ, Kallmes DF, Jensen ME et Al: Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils. Am J Neuroradiol 20: 308-310, 1999. DiMaio S, Mohr G, Dufour JJ et Al: Distal mycotic aneurysm of the AICA mimicking intracanalicular acoustic neuroma. Can J Neurol Sci 30: 388-392, 2003. Ebara M, Tanaka T, Sawauchi S et Al: A ruptured aneurysm of the anterior and posterior inferior cerebellar artery: a case report. No Shinkei Geka 27: 1013-1017, 1999. Eckard DA, O’Boynick PL, McPherson CM et Al: Coil occlusion of the parent artery for treatment of symptomatic peripheral intracranial aneurysms. Am J Neuroradiol 21: 137-142, 2000. Fukuya T, Kishikawa T, Ikeda J et Al: Aneurysms of the peripheral portion of the anterior inferior cerebellar artery: report of two cases. Neurosurgery 29: 493496, 1987. Hancock JH, Millar JS: Spontaneous dissection of the anterior inferior cerebellar artery. Neuroradiology 42: 535-538, 2000. Honda Y, Tanaka R, Kameyama S: Ruptured distal anterior inferior cerebellar artery aneurysm-case report. Neurol Med Chir (Tokyo) 34: 763-767, 1994. Ishikawa E, Yanaka K, Meguro K et Al: Treatment of peripheral aneurysms of the posterior circulation. No Shikei Geka 28: 337-343, 2000. Iwanaga S, Shrier DA, Okawara SH et Al: Value of CT angiography in the evaluation of a peripheral anterior inferior cerebellar artery aneurysm: case report. Clin Imaging 23: 77-80, 1999. Jayaraman MV, Mayo-Smith WW, Doberstein CE: Intracanalicular aneurysm of the anterior inferior cerebellar artery revealed by multi-detector CT angiography. Am J Neuroradiol 24: 1338-1340, 2003. Kaech D, de Tribolet N, Lasjaunias P: Anterior inferior cerebellar artery aneurysm, carotid bifurcation aneurysm, and dural arteriovenous malformation of the tentorium in the same patient. Neurosurgery 21: 575582, 1987. Kamiya K, Nagai H, Koide K et Al: Peripheral anterior inferior cerebellar artery aneurysms. Surg Neurol 42: 46-51, 1994. Kiya K, Uozumi T, Emoto K et Al: Anterior inferior cerebellar artery aneurysm at the internal auditory meatus-case report. Neurol Med Chir 29: 592-595, 1989. Kondoh T, Kurihara E, Kohmura E: Distal anterior inferior cerebellar artery aneurysm occult on magnetic resonance angiography one month prior to rupturecase report. Neurol Med Chir 43: 345-348, 2003. Kusaka N, Maruo T, Nishiguchi M et Al: Embolization for aneurysmal dilatation associated with ruptured dissecting anterior inferior cerebellar artery aneurysm with preservation of the parent artery: case report. No Shikei Geka 34: 729-734, 2006. Kyoshima K, Matsuda M, Handa J: Cerebral aneurysm of the distal anterior inferior cerebellar artery: case report. Nippon Geka Hokan 64: 139-145, 1995. Lv XL, Li YX, Liu AH et Al: Endovascular treatment of intracranial giant serpentine aneurysms. Neuroradiol J 20: 237-241, 2007. Maekawa M, Awaya S, Fukuda S et Al: A ruptured choroidal artery aneurysm of the anterior inferior cerebellar artery obliterated via the endovascular approach: case report. No Shinkei Geka 31: 523-527, 2003. Matsuyama T, Okuchi K, Norimoto K et Al: Ruptured dissecting anterior inferior cerebellar artery aneurysm - case report. Neuro Med Chir 42: 214-216, 2002. Menovsky T, Andre Grotenhuis J, Bartels RH: Aneurysm of the anterior inferior cerebellar artery (AICA)
The Neuroradiology Journal 21: 261-265, 2008
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36
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associated with high-flow lesion: report of two cases and review of literature. J Clin Neurosci 9: 207-211, 2002. Mizushima H, Kobayashi N, Yoshibaru S et Al: Aneurysm of the distal anterior inferior cerebellar artery at the medial branch: a case report and review of the literature. Surg Neurol 52: 137-142, 1999. Oana K, Murakami T, Beppu T et Al: Aneurysm of the distal anterior inferior cerebellar artery unrelated to the cerebellopontine angle: case report. Neurosurgery 28: 899-903, 1991. Pandey AS, Koebbe C, Rosenwasser RH et Al: Endovascular coil embolization of ruptured and unruptured posterior circulation aneuryms: review of a 10year experience. Neurosurgery 60: 626-637, 2007. Russegger L, Furtschegger A: Aneurysms of the anterior inferior cerebellar artery. A case report and review of the literature. Nervenarzt 61: 499-503, 1990. Saito A, Ezura M, Takahashi A et Al: An arterial dissection of the distal anterior inferior cerebellar artery treated by endovascular therapy. No Shikei Geta 28: 269-274, 2000. Saito R, Tominaga T, Ezura M et Al: Distal anterior inferior cerebellar artery aneurysms: report of three cases and literature review. No Shinkei Geka 29: 709714, 2001. Sarkar A, Link MJ: Distal anterior inferior cerebellar artery aneurysm masquerading as a cerebellopontine angle tumor: case report and review of literature. Skull Base 14: 101-107, 2004. Spallone A, De Santis S, Giuffre R: Peripheral aneurysms of the anterior inferior cerebellar artery. Case report and review of literature. Br J Neurosurg 9: 537541, 1995. Suzuki K, Meguro K, Wada M et Al: Embolization of a ruptured aneurysm of the distal anterior inferior cerebellar artery: case report and review of the literature. Surg Neurol 51: 509-512, 1999. Vincentelli F, Caruso G, Licastro G et Al: Association between an aneurysm of the anterior inferior cerebral artery and an arteriovenous malformation fed by the same artery. J Neurosurg Sci 42: 41-45, 1998. Yamakawa H, Hattori T, Tanigawara T et Al: Intracanalicular aneurysm at the meatal loop of the distal anterior inferior cerebellar artery: a case report and review of the literature. Surg Neurol 61: 82-88, 2004. Yokoyama S, Kadota K, Asakura T et Al: Aneurysm of the distal anterior inferior cerebellar artery - case report. Neuro Med Chir 35: 587-590, 1995. Yonekawa Y, Kaku Y, Imhof HG et Al: Posterior circulation aneurysms. Technical strategies based on angiographic anatomical findings and the results of 60 recent consecutive cases. Acta Neurochir Suppl 72: 123-140, 1999. Zager EL: Isolated trigeminal sensory loss secondary to a distal anterior inferior cerebellar artery aneurysm: case report. Neurosurgery 28: 288-291, 1991. Zager EL, Shaver EG, Hurst RW et Al: Distal anterior inferior cerebellar artery aneurysms. Report of four cases. J Neurosurg 97: 692-696, 2002.
Wu Zhongxue, MD Interventional Neuroradiology Department Beijing Neurosurgical Institution 6, Tiantan Xili Beijing, 100050 China Tel.: 86-10-67098850 E-mail: [email protected]
265
www. centauro. it
Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm A Case Report and Review of the Literature
XIANLI LV, YOUXIANG LI, AIHUA LIU, JINGBO ZHANG, ZHONGXUE WU Beijing Neurosurgical Institute; Beijing, China Beijing Tiantan Hospital, Capital Medical University; Beijing, China
Key words: aneurysm, anterior inferior cerebellar artery, coil embolization
SUMMARY – Most cases of aneurysms associated with the distal portion of the anterior inferior cerebellar artery resulted in a hearing disturbance from the surgical procedure, although aneurysms far from the auditory artery had no deficit from trapping. We describe a patient with an aneurysm at the distal segment of the anterior inferior cerebellar artery (AICA) treated endovascularly by parent artery occlusion.
Introduction Aneurysms of the distal anterior inferior cerebellar artery (AICA) are rare and almost all of them have been treated surgically, by clipping or trapping 1,7,8,12,15-19,21,25-27,31-33,35-37,39. We describe a patient with an aneurysm arising from the meatal loop of the AICA, which was cured by coil embolization of the parent artery. Case Report A 34-year-old woman experienced a sudden onset of severe headache and vomiting. Computed tomographic scanning revealed a right cerebellar and subarachnoid hemorrhage. Cerebral digital subtraction angiography (DSA) showed a saccular aneurysm distal to the meatal loop of the right AICA. General anesthesia was used, 5000 U of heparin was administered at the start of the procedure, followed by 1000 U every hour until completion. A catheter was placed in the common femoral artery and then passed up into the aortic arch, and selective catheterization of the right vertebral artery was performed. A microcatheter (Echelon 10, M.T.I) was passed in a coaxial fashion through the introducer
catheter followed by selective catheterization of the right AICA. The tip of the catheter was placed proximal to the aneurysm because the excessive tortuous vessel did not allow access to the aneurysm with the catheter, and coils were placed just proximal to the aneurysm. The artery was occluded with two 30 mm and two ×10 mm hydrocoils (Microvention). Angiography was performed after coil placement to confirm occlusion of the parent vessel and aneurysm. Anticoagulation treatment was given after the procedure. The patient demonstrated mild vertigo and diplopia while staring at something for three days. The patient was discharged normally on day five. Discussion Aneurysms of the distal anterior inferior cerebellar artery (AICA) are very rare 3,4,14,20,25,28,31,40. The most common clinical symptoms are subarachnoid hemorrhage (SAH) and dysfunction of the facial and acoustic nerves 10,12,18,29,33,37. Therefore SAH associated with symptoms of the facial and/or acoustic nerve suggests the rupture of a distal AICA aneurysm. Table 1 summarizes the treatment of AICA aneurysms 1,2,5,6-9,12,15-21,23-27,29,31-37,39 . 261
Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm
Xianli Lv
Table 1 Summary of reported cases. Author
Year
Presentation
Kaech D et Al 16
1987
SAH, cerebellar hemorrhage
Surgical clipping
No deficit
Kiya K et Al
1989
SAH, CNVII, VIII deficits
Surgical clipping
Improved
Russegger L et Al 28
1990
SAH
No
Died
Zager EL
1991
SAH, CNV deficit
Surgical excision
CNV deficit
Oana K et Al 26
1991
Intraventricular hemorrhage
Surgical clipping
No deficit
Kamiya K et Al 17
1994
SAH, CNVIII deficit
Surgical trapping
CNVIII deficit
SAH
Surgical clipping
No deficit
1994
SAH, CNVII, VIII deficits
Surgical clipping
CNVIII deficit
1995
SAH, CNVII, VIII deficits
Surgical trapping
No deficit
Yokoyama S et Al 36
1995
SAH, CNVII deficit
Surgical trapping
CNVIII deficit
Kyoshima K et Al
1995
SAH
Surgical clipping
No deficit
Vincentelli F et Al 34
1998
SAH, CPA syndrome
Surgical clipping
No deficit
Cloft HJ et Al
1999
SAH
PAO (coil)
No deficit
Suzuki K et Al 33
1999
SAH
PAO (coil)
No deficit
Mizushima H et Al 25
1999
Epilepsy
Surgical clipping
No deficit
Ebara M et Al 8
1999
SAH
Surgical clipping
No deficit
Eckard et Al 9
2000
SAH, no clinical deficit
PAO (coil)
CNVIII deficit
Saito Retal et Al 30
2001
SAH
Surgical clipping
CNVIII deficit
SAH
Surgical clipping
No deficit
SAH
PAO (coil)
CNVIII deficit
Cerebellar syndrome
Surgical wrapping
Enlargement
Cerebellar hemorrhage
Surgical clipping
No deficit
18
38
Honda Y et Al 12 Spallone A et Al
32
21
6
Menovsky T et Al 24
2002
Therapy
Clinical deficit after therapy
Matsuyama T et Al 23
2002
SAH
Endosaccular coiling
No deficit
Adorno JO et Al
2002
SAH
Surgical clipping
No deficit
Maekawa M et Al 22
2003
Intraventricular hemorrhage
PAO (coil)
No deficit
Jayaraman MV et Al 15
2003
SAH
Surgical trapping
No deficit
Kondoh T et Al 19
2003
SAH
Surgical clipping
Mild dysarthria
2003
Acute dizziness
Surgical excision
No deficit
2004
SAH
Surgical clipping
CNVII, VIII deficits
Sarkar A et Al 31
2004
CNVII, VIII deficits
Surgical trapping
No deficit
Akyuz M et Al
2005
SAH
No
Dizziness
2006
SAH
PAO (coil)
No deficit
2006
SAH
Endosaccular coiling
No deficit
2007
SAH, cerebellar hemorrhage
PAO (coil)
No deficit
1
DiMaio S et Al 7 Yamakawa H et Al
2
Choi CH et Al 5 Kusaka N et Al Present case
262
20
35
www. centauro. it
The Neuroradiology Journal 21: 261-265, 2008
Figure 1 CT scan demonstrating the intracerebellar hemorrhage.
The most common sign caused by surgical occlusion is VIIIth cranial nerve disturbance 31,37 . Clearly, AICA obstruction does not necessarily cause severe neurological deficits 10,14. Anastomoses must have been present between the AICA and the posterior inferior cerebellar artery in these patients 38. However, such anastomoses could be damaged by surgical manipulations. We think that endovascular treatment may be safer, simpler and more effective. An excellent outcome was obtained without significant complications in our patient with peripheral AICA aneurysm treated by parent vessel occlusion, unlike most cases previously reported in which a surgical procedure was used. It is our belief that as compared with balloons coils are more likely to create a permanent occlusion if the vessel is well packed 22. Balloons may deflate, resulting in recanalization of the aneurysm. Moreover, in our case, a balloon would have been more difficult or even impossible to navigate into position in the peripheral branches we occluded. Compared with glue, coils can be placed precisely, with less chance of distal embolization, which would block possible collateral branches.
Test injection with Amytal was not perform in our case because we believe that Amytal testing is overly predictive of deficits owing to its deep penetration into all of the peripheral vessels 6,9,13. When the vessel is actually occluded, collaterals may partially by-pass the occlusion, which accounts for the discrepancy. Fortunately, this patient experienced only transient mild vertigo and diplopia while staring at something. The patient has been through rehabilitation and has gradually improved. Endovascular obliteration is also a reasonable option, although the possibility of retrograde thrombosis of the AICA is a concern. Conclusion For aneurysms distal to branches coursing to the brainstem, parent artery occlusion is a viable option that does not require by-pass. Intravascular treatment of distal AICA aneurysms remote from the auditory artery may be safer and simpler than surgical treatment. This report summarized previous cases and discuss the treatment of aneurysms of the AICA through a review of the literature. 263
Parent Artery Occlusion for Peripheral Anterior Inferior Cerebellar Artery Aneurysm
A
B
C
D
Xianli Lv
Figure 2 A) 3D reconstruction of the right vertebral injection showing an aneurysm in the distal portion of the AICA. Right vertebral angiogram, anteroposterior (B) and lateral (C) views after the procedure showing complete occlusion of the parent artery and the aneurysm. D) Skull X-ray film showing coil deposition.
References 1 Adorno JQ, de Andrade GC: Aneurysm of the anterior inferior cerebellar artery: case report. Arq Neuropsiquiatr 60: 1019-1024, 2002. 2 Akyuz M, Tuncer R: Multiple anterior inferior cerebellar artery aneurysms associated with an arteriovenous malformation: case report. Surg Neurol 64: 106-108, 2005.
264
3 Andreou A, Ioannidis I, Mitsos A: Endovascular treatment of peripheral intracranial aneurysms. Am J Neuroradiol 28: 355-361, 2007. 4 Andaluz N, Pensak ML, Zuccarello M: Multiple, peripheral aneurysm of the anterior inferior cerebellar artery. Acta Neurochir 147: 419-422, 2005. 5 Choi CH, Cho WH, Choi BK et Al: Rerupture following
www. centauro. it
6
7 8
9
10
11 12 13 14
15
16
17 18 19
20
21 22 23
24 25
endovascular treatment for dissecting aneurysm of distal anterior inferior cerebellar artery with parent artery preservation: retreatment by parent artery occlusion with Guglielmi detachable coils. Acta Neurochir 148: 363-366, 2006. Cloft HJ, Kallmes DF, Jensen ME et Al: Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils. Am J Neuroradiol 20: 308-310, 1999. DiMaio S, Mohr G, Dufour JJ et Al: Distal mycotic aneurysm of the AICA mimicking intracanalicular acoustic neuroma. Can J Neurol Sci 30: 388-392, 2003. Ebara M, Tanaka T, Sawauchi S et Al: A ruptured aneurysm of the anterior and posterior inferior cerebellar artery: a case report. No Shinkei Geka 27: 1013-1017, 1999. Eckard DA, O’Boynick PL, McPherson CM et Al: Coil occlusion of the parent artery for treatment of symptomatic peripheral intracranial aneurysms. Am J Neuroradiol 21: 137-142, 2000. Fukuya T, Kishikawa T, Ikeda J et Al: Aneurysms of the peripheral portion of the anterior inferior cerebellar artery: report of two cases. Neurosurgery 29: 493496, 1987. Hancock JH, Millar JS: Spontaneous dissection of the anterior inferior cerebellar artery. Neuroradiology 42: 535-538, 2000. Honda Y, Tanaka R, Kameyama S: Ruptured distal anterior inferior cerebellar artery aneurysm-case report. Neurol Med Chir (Tokyo) 34: 763-767, 1994. Ishikawa E, Yanaka K, Meguro K et Al: Treatment of peripheral aneurysms of the posterior circulation. No Shikei Geka 28: 337-343, 2000. Iwanaga S, Shrier DA, Okawara SH et Al: Value of CT angiography in the evaluation of a peripheral anterior inferior cerebellar artery aneurysm: case report. Clin Imaging 23: 77-80, 1999. Jayaraman MV, Mayo-Smith WW, Doberstein CE: Intracanalicular aneurysm of the anterior inferior cerebellar artery revealed by multi-detector CT angiography. Am J Neuroradiol 24: 1338-1340, 2003. Kaech D, de Tribolet N, Lasjaunias P: Anterior inferior cerebellar artery aneurysm, carotid bifurcation aneurysm, and dural arteriovenous malformation of the tentorium in the same patient. Neurosurgery 21: 575582, 1987. Kamiya K, Nagai H, Koide K et Al: Peripheral anterior inferior cerebellar artery aneurysms. Surg Neurol 42: 46-51, 1994. Kiya K, Uozumi T, Emoto K et Al: Anterior inferior cerebellar artery aneurysm at the internal auditory meatus-case report. Neurol Med Chir 29: 592-595, 1989. Kondoh T, Kurihara E, Kohmura E: Distal anterior inferior cerebellar artery aneurysm occult on magnetic resonance angiography one month prior to rupturecase report. Neurol Med Chir 43: 345-348, 2003. Kusaka N, Maruo T, Nishiguchi M et Al: Embolization for aneurysmal dilatation associated with ruptured dissecting anterior inferior cerebellar artery aneurysm with preservation of the parent artery: case report. No Shikei Geka 34: 729-734, 2006. Kyoshima K, Matsuda M, Handa J: Cerebral aneurysm of the distal anterior inferior cerebellar artery: case report. Nippon Geka Hokan 64: 139-145, 1995. Lv XL, Li YX, Liu AH et Al: Endovascular treatment of intracranial giant serpentine aneurysms. Neuroradiol J 20: 237-241, 2007. Maekawa M, Awaya S, Fukuda S et Al: A ruptured choroidal artery aneurysm of the anterior inferior cerebellar artery obliterated via the endovascular approach: case report. No Shinkei Geka 31: 523-527, 2003. Matsuyama T, Okuchi K, Norimoto K et Al: Ruptured dissecting anterior inferior cerebellar artery aneurysm - case report. Neuro Med Chir 42: 214-216, 2002. Menovsky T, Andre Grotenhuis J, Bartels RH: Aneurysm of the anterior inferior cerebellar artery (AICA)
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Wu Zhongxue, MD Interventional Neuroradiology Department Beijing Neurosurgical Institution 6, Tiantan Xili Beijing, 100050 China Tel.: 86-10-67098850 E-mail: [email protected]
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