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
