Intrameatal thrombosed anterior inferior cerebellar artery aneurysm mimicking a vestibular schwannoma.
Aneurysms of the anterior inferior cerebellar artery (AICA) are a rare entity. Purely intrameatal aneurysms are even rarer. The authors report an intrameatal thrombosed AICA aneurysm mimicking a vestibular schwannoma that was treated by resection and end-to-end anastomosis. This 22-year-old man presented with acute hearing loss, vertigo, and moderate facial palsy. Magnetic resonance imaging showed an atypical intrameatal lesion with dilation of the internal auditory canal. Microsurgical inspection via a retrosigmoid approach and drilling of the posterior wall of the internal auditory canal revealed a thrombosed AICA aneurysm. The aneurysm was excised, and an end-to-end suture was performed to restore AICA continuity. Intraoperative indocyanine green videoangiography as well as postoperative digital substraction angiography showed a good revascularization. Intrameatal AICA aneurysms may present with symptoms similar to vestibular schwannomas. End-to-end reanastomosis after aneurysm resection is a treatment option when clipping is impossible.
Department of Neurosurgery, Ernst Moritz Arndt University, Greifswald, Germany. paeslerd@uni-greifswald.de
Dennis
D
Päsler
Jörg
J
Baldauf
Uwe
U
Runge
Henry W S
HW
Schroeder
D015901:Angiography, Digital Subtraction; D002526:Cerebellar Diseases / Q000473:pathology*; D002531:Cerebellum / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000473:pathology*; D005158:Facial Paralysis / Q000209:etiology; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology*; D020767:Intracranial Thrombosis / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D009464:Neuroma, Acoustic / Q000473:pathology*; D019635:Neurosurgical Procedures; D014057:Tomography, X-Ray Computed; D014717:Vertigo / Q000209:etiology; D000160:Vestibulocochlear Nerve Diseases / Q000473:pathology; D055815:Young Adult