Title

Treatment of an anterior inferior cerebellar artery aneurysm with microsurgical trapping and in situ posterior inferior cerebellar artery to anterior inferior cerebellar artery bypass: Case report

Document Type

Article

Abstract

Copyright © 2017 by the Congress of Neurological Surgeons. BACKGROUND: Anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can involve microsurgical and/or endovascular techniques. Such treatment can be challenging and may carry a significant risk of neurological morbidity. OBJECTIVE: To demonstrate a case involving a complex AICA aneurysm that was treated with a unique microsurgical approach involving trapping the aneurysm and performing in Situ bypass from the posterior inferior cerebellar artery (PICA) to the distal AICA. The nuances of AICA aneurysms and revascularization strategies are discussed. METHODS: The aneurysm and the distal segments of AICA and PICA were exposed with a retrosigmoid and far lateral approach. A side-to-side anastomosis was performed between the adjacent caudal loops of PICA and AICA. The AICA aneurysm was then treated by trapping the aneurysm-bearing segment of the parent vessel between 2 clips. RESULTS: A postoperative angiogram demonstrated a patent PICA-AICA bypass and complete occlusion of the AICA aneurysm. There were no complications, and the patient made an excellent recovery. CONCLUSION: The combination of parent vessel sacrifice and bypass remains an excellent option for certain difficult-to-treat aneurysms. This case involving PICA-AICA bypass to treat an AICA aneurysm serves as an example of the neurosurgeon’s ability to develop unique solutions that take advantage of individual anatomy.

Publication Date

10-1-2018

Publication Title

Operative Neurosurgery

ISSN

23324252

E-ISSN

23324260

Volume

15

Issue

4

First Page

418

Last Page

424

PubMed ID

29301049

Digital Object Identifier (DOI)

10.1093/ons/opx275

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