Intracanalicular aneurysm at the meatal loop of the distal anterior inferior cerebellar artery: a case report and review of the literature.
BACKGROUND
Distal aneurysms of the anterior inferior cerebellar artery (AICA) are rare. Most of the reported cases have been located near the internal auditory meatus. Among these cases, only six located in the internal auditory meatus have been reported in the literature.


METHODS
A 64-year-old female presented with sudden onset of severe headache. Computed tomography (CT) revealed moderate subarachnoid hemorrhage and Gd-DTPA enhanced magnetic resonance imaging (MRI) showed a small high-intensity mass at the right cerebellopontine angle. Although initial digital subtraction angiography (DSA) showed no vascular abnormalities, repeated DSA disclosed a saccular aneurysm at the top of the meatal loop of the right AICA. The patient underwent a suboccipital craniectomy on the 18th day after the hemorrhage


RESULTS
. In this case, the aneurysm was completely buried in the internal auditory meatus. After unroofing the meatus, the aneurysm was successfully clipped. After 3 months of hospitalization, the patient was discharged with right-sided deafness, partial facial palsy, and no other complications.


CONCLUSIONS
We discuss some of the clinical features and pitfalls in the surgical management of intracanalicular AICA aneurysms and review previous reports of similar cases.
Yamakawa
Haruki
H
Department of Neurosurgery, Gifu University School of Medicine, Noishiki, Japan.
Hattori
Tatsuaki
T
Tanigawara
Tetsuya
T
Sahashi
Yukiko
Y
Ohkuma
Akio
A
D002531:Cerebellum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology; D003287:Contrast Media; D003937:Diagnosis, Differential; D007758:Ear, Inner; D005260:Female; D019786:Gadolinium DTPA; D006261:Headache / Q000175:diagnosis; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery
D003287:Contrast Media; D019786:Gadolinium DTPA