Abstract
Background Distal cerebellar artery aneurysms are rare entities and treatment modalities technically
challenging. In recent years, new therapeutic options have emerged through microsurgical
and endovascular means.
Objective Based on a series of 11 cases, we describe combined interdisciplinary treatment strategies
and report the outcome in a midterm follow-up interval of 12 months.
Methods Collection of clinical case data during acute phase and follow-up including standardized
angiographic control intervals during follow-up and assessment of the outcome.
Results 7 of 11 reported cases had flow-related aneurysms based on an underlying arteriovenous
malformation (AVM) or dural arteriovenous fistula (DAVF); we found multiple aneurysms
in four cases. All patients with flow-related aneurysms presented with subarachnoid
hemorrhage (SAH). Only one of four patients in this series without an underlying AVM
or DAVF presented with SAH that was attributable to a distal cerebellar aneurysm.
In one case, we observed a de novo formation of two flow-associated distal aneurysms
(10 years interval). Two patients were treated conservatively, five patients were
treated endovascularly, one patient was treated surgically and three patients were
treated with combined methods. 9 of 11 patients with initial SAH had a good outcome.
Conclusions Distal cerebellar aneurysms associated with AVM or DAVF are rare but characterized
by a high risk of hemorrhage. The present series indicates that an experienced interdisciplinary
team and the combination of available techniques may lead to a reduction of complications
and to a better outcome.
Keywords
intracranial aneurysm - arteriovenous malformation - posterior fossa - SAH
