Treatment and Outcome of Anterior Inferior Cerebellar Artery (AICA) Aneurysms: Helsinki Series of 15 Consecutive Patients

Sajjad Muhammad; Ahmad Hafez; Hanna Kaukovalta; Behnam Rezai Jahromi; Riku Kivisaari; Daniel Hänggi; Mika Niemelä

doi:10.1055/s-0042-1758844

Treatment and Outcome of Anterior Inferior Cerebellar Artery (AICA) Aneurysms: Helsinki Series of 15 Consecutive Patients

Asian J Neurosurg. 2023 Mar 10;18(1):30-35. doi: 10.1055/s-0042-1758844. eCollection 2023 Mar.

Authors

Sajjad Muhammad^{1

2}, Ahmad Hafez², Hanna Kaukovalta², Behnam Rezai Jahromi², Riku Kivisaari², Daniel Hänggi¹, Mika Niemelä²

Affiliations

¹ Department of Neurosurgery, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
² Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.

Abstract

Objective Anterior inferior cerebellar artery (AICA) aneurysms are rare posterior circulation lesions that are challenging to treat. This article presents the treatment and clinical outcome of AICA aneurysms in an unselected cohort of patients. Methods A retrospective analysis of patient record files, digital subtraction angiography, and computed tomography angiography images of 15 consecutive patients harboring AICA aneurysms treated between 1968 and 2017. Results Of the 15 AICA aneurysm patients reviewed, 12 (80%) were females. Twenty percent had intracerebral hemorrhage and 40% presented with intraventricular hemorrhage. Eleven out of 15 (73%) patients presented with subarachnoid hemorrhage (SAH); 82% of SAH patients had a good-grade SAH (Hunt and Hess grade 1-3). Eleven patients (73%) were treated surgically, three (20%) were treated conservatively, and one (7%) had coil embolization. In 27% of patients, a subtemporal approach with anterior petrosectomy was performed. A retrosigmoid approach was used in the remaining 73%. In 18% of the patients, a parent vessel occlusion was necessary to occlude the aneurysm. Five out of 11 (47%) of the patients developed postoperative cranial nerve deficits. Twenty-seven percent developed shunt-dependent hydrocephalus. All patients who presented with an unruptured AICA aneurysm had good clinical outcome (modified Rankin scale [mRS] 1-2). In patients with SAH, 82% achieved good clinical outcome and 18% had poor clinical outcome (mRS 3-6) after 1 year. Conclusion Surgical treatment of AICA aneurysms has a high rate of cranial nerve deficits but most of patients have a good long-term clinical outcome.

Keywords: DSA and CT angiography; anterior inferior cerebellar artery (AICA) aneurysms; intracerebral hemorrhage; intraventricular hemorrhage.

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