A case of ruptured distal anterior inferior cerebellar artery aneurysm treated by intra-aneurysmal embolization

Takao Sasaki; Hidefumi Tabata; Hana Tobishima; Takahiro Morita; Kosuke Katayama; Atsushi Saito

doi:10.25259/SNI_400_2025

A case of ruptured distal anterior inferior cerebellar artery aneurysm treated by intra-aneurysmal embolization

Surg Neurol Int. 2025 Jul 11:16:284. doi: 10.25259/SNI_400_2025. eCollection 2025.

Authors

Takao Sasaki¹, Hidefumi Tabata², Hana Tobishima², Takahiro Morita³, Kosuke Katayama³, Atsushi Saito³

Affiliations

¹ Department of Neurosurgery, Hirosaki University, Hirosaki, Japan.
² Department of Neurosurgery, Aomori City Hospital, Hirosaki, Japan.
³ Department of Neurosurgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Abstract

Background: Endovascular treatment for true anterior inferior cerebellar artery (AICA) aneurysm is challenging for preserving the AICA trunk. Ischemic tolerance of the sacrifice of AICA is controversial. We report a rare case of ruptured distal AICA aneurysm treated by intra-aneurysmal embolization preserving the AICA trunk.

Case description: A 77-year-old woman presented with a sudden headache and computed tomography showed a subarachnoid hemorrhage predominant in the left cerebellopontine angle. Cerebral angiography revealed a saccular aneurysm in the anterior pontine segment of the left AICA. Coil embolization underwent preserving the parent artery. There is no recanalization of the aneurysm at 26 months postoperatively. In this case, hemodynamic stress was suggested to be involved in the development of the aneurysm.

Conclusion: For the patients in the old or at high risk of ischemia, intra-aneurysmal embolization should be tried as the first-line treatment.

Keywords: Distal anterior inferior cerebellar aneurysm; Intra-aneurysmal embolization; Subarachnoid hemorrhage.

Publication types

Case Reports