2018 Volume 3 Issue 1 Pages 29-34
Objective: We report a case of a ruptured saccular aneurysm at the anterior pontine segment of the anterior inferior cerebellar artery (AICA) treated by intra-aneurysmal coil embolization.
Case presentation: A 47-year-old woman presented with headache and disturbance of consciousness. Computed tomographic scan demonstrated subarachnoid hemorrhage predominantly in the prepontine and left cerebellopontine angle cistern. Digital subtraction angiography demonstrated no evident source of bleeding. Repeat angiography on day 8 revealed a saccular aneurysm at the anterior pontine segment of the left AICA accompanied with the absence of the left posterior inferior cerebellar artery (PICA). This saccular aneurysm was occluded by intra-aneurysmal coil embolization with preservation of the left AICA.
Conclusion: The anterior pontine segment AICA aneurysm is rare and only 8 cases have been reported. Congenital vulnerability of the vascular wall and hemodynamic stress due to the aplasia of the ipsilateral PICA were possibly associated with the development of the aneurysm in this case. Preservation of the parent artery and long-term complete occlusion of the aneurysm was achieved by intra-aneurysmal coil embolization. It would be the most effective therapeutic option for this aneurysm by the advances in the devices and techniques of endovascular treatment.
