Mahmoud M, El Serwi A, Alaa Habib M, Abou Gamrah S
Radiology Department, Ain Shams University, Cairo, Egypt.
Interv Neuroradiol. 2012 Dec;18(4):449-57. doi: 10.1177/159101991201800411. Epub 2012 Dec 3.
Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare, accounting for less than 1% of all cerebral aneurysms. To our knowledge 34 flow-related cases including the present study have been reported in the literature. Three patients harbouring four flow dependent aneurysms were referred to our institution. Two patients presented with subarachnoid hemorrhage, one presented with cerebellar manifestations. They were all treated by endovascular embolization of the aneurysm as well as the parent artery using liquid embolic material. Two cases were embolized using NBCA, Onyx was used in the third case. No bleeding or rebleeding were encountered during the follow-up period which ranged from five to nine months. One patient developed facial palsy, cerebellar symptoms and sensorineural hearing loss. The remaining two cases did not develop any post treatment neurological complications. Endovascular management of flow-dependent AICA aneurysms by parent artery occlusion is feasible and efficient in terms of rebleeding prevention. Post embolization neurological complications are unpredictable. This depends upon the adequacy of collaterals from other cerebellar arteries.
小脑前下动脉（AICA）周围动脉瘤较为罕见，占所有脑动脉瘤的比例不到1%。据我们所知，包括本研究在内，文献中已报道了34例血流相关病例。三名患有四个血流依赖性动脉瘤的患者被转诊至我院。两名患者表现为蛛网膜下腔出血，一名患者表现为小脑症状。他们均接受了使用液体栓塞材料对动脉瘤及其载瘤动脉进行血管内栓塞治疗。两例使用NBCA进行栓塞，第三例使用Onyx。在5至9个月的随访期内未发生出血或再出血。一名患者出现面瘫、小脑症状和感音神经性听力损失。其余两例未出现任何治疗后神经并发症。通过闭塞载瘤动脉对血流依赖性AICA动脉瘤进行血管内治疗在预防再出血方面是可行且有效的。栓塞后神经并发症不可预测。这取决于其他小脑动脉侧支循环的充分程度。
