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CC BY-NC-ND 4.0 · Asian J Neurosurg 2023; 18(01): 030-035
DOI: 10.1055/s-0042-1758844
Original Article

Treatment and Outcome of Anterior Inferior Cerebellar Artery (AICA) Aneurysms: Helsinki Series of 15 Consecutive Patients

Sajjad Muhammad
1   Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
2   Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
,
Ahmad Hafez
2   Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
,
Hanna Kaukovalta
2   Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
,
Behnam Rezai Jahromi
2   Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
,
Riku Kivisaari
2   Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
,
Daniel Hänggi
1   Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
,
Mika Niemelä
2   Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Abstract

Objective Anterior inferior cerebellar artery (AICA) aneurysms are rare posterior circulation lesions that are challenging to treat. This article presents the treatment and clinical outcome of AICA aneurysms in an unselected cohort of patients.

Methods A retrospective analysis of patient record files, digital subtraction angiography, and computed tomography angiography images of 15 consecutive patients harboring AICA aneurysms treated between 1968 and 2017.

Results Of the 15 AICA aneurysm patients reviewed, 12 (80%) were females. Twenty percent had intracerebral hemorrhage and 40% presented with intraventricular hemorrhage. Eleven out of 15 (73%) patients presented with subarachnoid hemorrhage (SAH); 82% of SAH patients had a good-grade SAH (Hunt and Hess grade 1–3). Eleven patients (73%) were treated surgically, three (20%) were treated conservatively, and one (7%) had coil embolization. In 27% of patients, a subtemporal approach with anterior petrosectomy was performed. A retrosigmoid approach was used in the remaining 73%. In 18% of the patients, a parent vessel occlusion was necessary to occlude the aneurysm. Five out of 11 (47%) of the patients developed postoperative cranial nerve deficits. Twenty-seven percent developed shunt-dependent hydrocephalus. All patients who presented with an unruptured AICA aneurysm had good clinical outcome (modified Rankin scale [mRS] 1–2). In patients with SAH, 82% achieved good clinical outcome and 18% had poor clinical outcome (mRS 3–6) after 1 year.

Conclusion Surgical treatment of AICA aneurysms has a high rate of cranial nerve deficits but most of patients have a good long-term clinical outcome.

Keywords

anterior inferior cerebellar artery (AICA) aneurysms - DSA and CT angiography - intracerebral hemorrhage - intraventricular hemorrhage


Publication History

Article published online:
10 March 2023

© 2023. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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