Spontaneous dissection of the anterior inferior cerebellar artery

A patient presented with the clinical features of a brain stem infarct. MRI confirmed changes of infarction but also revealed an unusual lesion in the left cerebellopontine angle cistern. The evolution of this lesion on MRI, together with angiographic changes, indicated a dissecting aneurysm of the left anterior inferior cerebellar artery, a previously unreported phenomenon. The presentation, causes and diagnosis of intracranial dissection are discussed. Received: 2 September 1999 Accepted: 16 September 1999     

小脑前下动脉的显微解剖应用研究

目的:探讨小脑前下动脉的显微解剖特点及其变异特征,明确小脑前下动脉与相邻颅骨、颅神经的比邻关系与供血范围,为临床该区域的小脑肿瘤外科手术、微血管减压术及介入手术等提供解剖学依据。方法:利用12具24侧福尔马林固定的成人脑标本,对小脑前下动脉进行显微解剖,观察、测量、统计血管的数目,走行、分支情况及其与周围神经的关系。结果:小脑前下动脉管径在0.52mm～1.83mm之间,平均(1.23±0.41)mm。AICA出现率为100%。其分支迷路动脉、回返穿动脉、弓下动脉和小脑弓下动脉,出现率分别为100%,87.5%,79.2%及8.3%。AICA在面神经根附近形成AICA袢出现率为90%。AICA袢与内耳门关系密切,80%穿过面、蜗神经。结论:小脑前下动脉存在较大变异,与周围的三叉神经,面、蜗神经关系密切,熟悉颅底血管的显微外科解剖,重视血管的复杂变异,才能避免桥小脑角术中损伤相关血管。     

Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously reported cases of moyamoya disease associated with persistent carotid-basilar arterial anastomosis and investigated the embryology of this rare arterial variation.     

Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

European Radiology - The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously...     

小脑后下动脉瘤血管内栓塞治疗的初步临床研究

目的 探讨小脑后下动脉(PICA)瘤栓塞治疗的方法及效果.方法 回顾性分析21例PICA瘤经血管内栓塞治疗的临床资料,根据DSA资料估计动脉瘤的解削分段.采取单纯弹簧圈栓塞8例、单纯液体胶栓塞5例、弹簧圈联合液体胶栓塞2例、支架辅助弹簧圈栓塞2例、球囊辅助弹簧圈PICA闭塞4例,用格拉斯哥预后(GOS)评分评估疗效.结果 单纯弹簧圈致密栓塞5例,90%以上栓塞2例,85%栓寒1例;单纯液体胶栓塞的5例及弹簧圈联合液体胶栓塞的2例均达到致密栓塞;支架辅助弹簧圈栓塞的2例90%以上栓塞;球囊辅助弹簧圈完全闭塞载瘤动脉3例,90%以上栓塞1例.术后脑干穿支动脉闭塞导致死亡1例,术后1周新发神经功能障碍1例,其余未见再出血及小脑损害症状.术后随访6～60个月,平均(22±8)个月.COS评分Ⅰ级1例,Ⅱ级1例,Ⅲ级2例,Ⅳ级5例,Ⅴ级12例.结论 根据PICA瘤的解剖分段选择不同的栓塞方法,可取得良好的治疗效果.     

Anomalous origin of the anterior inferior cerebellar arteries from the internal carotid artery

Summary Two cases of the anterior inferior cerebellar arteries originating from the cavernous and precavernous segments of the internal carotid artery are reported. In one case the course of the anomalous artery was confirmed by autopsy. This anomalous artery is considered to be a variant of persistent primitive trigeminal artery. The clinical significance is discussed briefly.     

Intracanalicular aneurysm of the anterior inferior cerebellar artery revealed by multi-detector CT angiography

A 62-year-old woman had sudden-onset headache and posterior neck pain, and a subarachnoid hemorrhage was revealed by unenhanced CT. Both multi-detector CT angiography and digital subtraction angiography were performed and revealed a small intracanalicular aneurysm of the left anterior inferior cerebellar artery. The patient underwent successful retrosigmoid craniectomy and trapping of the aneurysm. This case shows the ability of multi-detector CT angiography to indicate bony landmarks that can alter the surgical approach.     

Anomalous origin of the posterior meningeal artery from the lateral medullary segment of the posterior inferior cerebellar artery

Summary The authors present two cases of angiographically-confirmed anomalous origin of the posterior meningeal artery (PMA) from the lateral segment of the posterior inferior cerebellar artery (PICA) and describe briefly the probable embryogenesis of this anomaly.     

Value of CT angiography in the evaluation of a peripheral anterior inferior cerebellar artery aneurysm: case report.

We report a case of a peripheral anterior inferior cerebellar artery (AICA) aneurysm in a 66-year-old woman. Computed tomography angiography (CTA) demonstrated a saccular aneurysm in the left AICA. A subsequent vertebral digital subtraction angiography using our standard injection technique failed to demonstrate the aneurysm. However, the aneurysm was visualized on a follow-up injection performed with an increased contrast dose and injection rate. CTA proved to be critical in the detection of this aneurysm which could have been easily overlooked on a conventional angiogram.     

Anomalous origin of the posterior inferior cerebellar artery from the internal carotid artery.

A rare anomalous origin of the posterior inferior cerebellar artery arising from the internal carotid artery is described. The embryologic explanation postulated is the persistence of a primitive communicating vessel (presegmental artery) between the anterior and posterior circulation.     

Posterior inferior cerebellar artery aneurysm in the fourth ventricle

We report a patient with a ruptured aneurysm of the choroidal branch of the right posterior inferior cerebellar artery (PICA), lying in and causing an isolated haemorrhage in the fourth ventricle. MRI on the first day after bleeding revealed an abnormal vessel in the fourth ventricle, which was surrounded by a mass of intermediate signal on T1- and T2-weighted images. The aneurysm was clipped via partial splitting of the lower vermis and opening the inferior medullary velum. A postoperative angiogram confirmed complete obliteration of the aneurysm. With PICA aneurysms the rate of intraventricular haemorrhage is high and in most cases due to reflux of blood. It there is an isolated intraventricular haemorrhage, a peripheral PICA aneurysm, lying in or near the fourth ventricle, may be suspected.     

Aneurysms of the peripheral portion of the anterior inferior cerebellar artery; Report of two cases

Summary Two cases of extremely rare aneurysms of peripheral portions of the AICA are reported with a review of the pertinent literature. According to reported surgical findings, nearly all of the aneurysms originated from arterial loops near the internal acoustic meatus. These aneurysms can therefore, cause the cerebellopontine angle syndrome, with or without subarachnoid hemorrhage.     

The posterior inferior cerebellar artery originating from the internal carotid artery,associated with multiple aneurysms

Summary We report the rare case of ipsilateral posterior inferior cerebellar artery originating from the carotid artery, and associated with multiple concurrent aneurysms. This is the 23rd reported case of carotid-cerebellar anastomosis and the first case with three concurrent aneurysms reported in the literature. Of the 23 cases, 6 had single aneurysms, 2 had double aneurysms and the present case had triple aneurysms.