Hendricks Benjamin K, Spetzler Robert F
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Oper Neurosurg (Hagerstown). 2020 Apr 1;18(4):E111. doi: 10.1093/ons/opz416.
Aneurysms of the anterior inferior cerebellar artery (AICA) are rare and require a considerate approach to facilitate successful and safe clipping. Surgical approaches vary and are dependent on the relation of the aneurysm to the internal acoustic meatus. An anterior approach should be considered for lesions medial to the meatus. Lesions adjacent to the meatus can be approached via a retrosigmoid or translabyrinthine approach. Lesions lateral to the meatus can be approached via a retrosigmoid or far lateral approach. This patient had a previously ruptured AICA aneurysm in the meatal region for which a retrosigmoid approach was selected. The approach involved locating the AICA distally and tracking it proximally to the origin off the basilar artery. A clip was applied across the aneurysm neck to facilitate occlusion while preserving parent vessel flow. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.
小脑前下动脉（AICA）动脉瘤较为罕见，需要采用周全的方法以实现成功且安全的夹闭。手术入路各不相同，取决于动脉瘤与内听道的关系。对于位于内听道内侧的病变，应考虑采用前路入路。与内听道相邻的病变可通过乙状窦后或经迷路入路进行处理。位于内听道外侧的病变可通过乙状窦后或远外侧入路进行处理。该患者曾有一例位于内听道区域的AICA动脉瘤破裂，为此选择了乙状窦后入路。该入路包括在远端定位AICA，并向近端追踪至其从基底动脉发出的起始处。在动脉瘤颈部夹闭以促进闭塞，同时保留母血管血流。患者已签署手术及录像知情同意书。机构审查委员会批准被认为不必要。经亚利桑那州凤凰城巴罗神经学研究所许可使用。
