Endovascular treatment of proximal anterior inferior cerebellar artery ruptured aneurysm: a case report

Abstract

Objective: We report a rare case of a ruptured aneurysm at proximal portion of the anterior inferior cerebellar artery (AICA) treated by endovascular coil embolization with AICA preservation.
Case: The patient was a 61-year-old woman with a World Federation of Neurosurgical Societies (WFNS) Grade II subarachnoid hemorrhage due to an aneurysm rupture in the right proximal AICA. Technical difficulty of catheter control caused by severe stenosis proximal to the aneurysm and tortuosity of the AICA, resulted in insufficient occlusion of aneurysm. Strict follow-up with repeated angiography revealed no recanalization of the aneurysm. The aneurysm and AICA was finally occluded at the 20-month follow-up with good collateral flow to the affected territory via the right superior cerebellar artery and the left posterior inferior cerebellar artery. Patient has been clinically stable for 4.5 years since the onset without any aneurysmal rebleeding.
Conclusions: All cases of proximal AICA aneurysms were reported as dissection or fusiform aneurysm, associated with hypoplasia or absence of the ipsilateral posterior inferior cerebellar artery. Although result of initial endovascular treatment was incomplete due to technical difficulty, patient has been stable without any aneurysmal regrowth nor rebleeding. We consider that our experience is one of the reference to investigate similar cases.