Endovascular Treatment for Ruptured Distal Anterior Inferior Cerebellar Artery Aneurysm.
10.7461/jcen.2014.16.1.20
- Author:
Jae Sang OH
1
;
Seok Mann YOON
;
Jai Joon SHIM
;
Hack Gun BAE
;
Il Gyu YOON
Author Information
1. Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. smyoon@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Subarachnoid hemorrhage;
Cerebellar artery;
Endovascular;
Hearing loss
- MeSH:
Adult;
Aneurysm*;
Angiography, Digital Subtraction;
Arteries*;
Cerebellopontine Angle;
Cerebral Hemorrhage;
Female;
Fourth Ventricle;
Hair;
Hearing Loss;
Hearing Loss, Sensorineural;
Hearing Loss, Unilateral;
Hemorrhage;
Humans;
Ischemia;
Running;
Subarachnoid Hemorrhage;
Tinnitus
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2014;16(1):20-25
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 42-year-old woman presented with Hunt and Hess grade (HHG) III subarachnoid hemorrhage (SAH) caused by a ruptured left distal anterior inferior cerebellar artery (AICA) aneurysm. Computed tomography showed a thin SAH on the cerebellopontine angle cistern, and small vermian intracerebral hemorrhage and intraventricular hemorrhage in the fourth ventricle. Digital subtraction angiography revealed the aneurysm on the postmeatal segment of left distal AICA, a branching point of rostrolateral and caudomedial branch of the left distal AICA. Despite thin caliber, tortuous running course and far distal location, the AICA aneurysm was obliterated successfully with endovascular coils without compromising AICA flow. However, the patient developed left side sensorineural hearing loss postoperatively, in spite of definite patency of distal AICA on the final angiogram. She was discharged home without neurologic sequela except hearing loss and tinnitus. Endovascular treatment of distal AICA aneurysm, beyond the meatal loop, is feasible while preserving the AICA flow. However, because the cochlear hair cell is vulnerable to ischemia, unilateral hearing loss can occur, possibly caused by the temporary occlusion of AICA flow by microcatheter during endovascular treatment.
