Document Detail


Anteroinferior cerebellar artery aneurysms: surgical approaches and outcomes--a review of 34 cases.
MedLine Citation:
PMID:  15509309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Anteroinferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment requires expertise in vascular, endovascular, and cranial base surgery. This article presents the largest series treated at one center. METHODS: We retrospectively analyzed presenting symptoms, aneurysm characteristics, surgical approaches, postoperative outcomes, and the application of endovascular techniques. RESULTS: We found 32 patients with 34 AICA aneurysms (11 men and 21 women; age range, 6-77 yr; mean age, 51 yr). Twenty-one aneurysms had ruptured; 13 were unruptured. Seven of the unruptured aneurysms presented with brainstem compression, and six were found incidentally. Surgical approaches included the retrosigmoid, far-lateral transcochlear, translabyrinthine, and orbitozygomatic. Eighteen patients (56%) had neurological complications. Thirty aneurysms were at proximal locations, and four were distal. Intraoperative hypothermic cardiac arrest was used to clip eight giant aneurysms. Follow-up was available in 56% of the patients for a mean of 41 months. The mean Glasgow Outcome Scale scores at discharge were not significantly different from the patients' status at their initial assessment. CONCLUSION: We recommend the standard retrosigmoid approach for treating small to medium aneurysms involving the lower two-thirds of the clivus or distal AICA aneurysms. Cranial base approaches are recommended for large or giant aneurysms or for those proximal to the emergence of the AICA from the basilar trunk. Hypothermic cardiac arrest facilitates dissection of giant aneurysms. Endovascular treatment is a useful adjunct for treating residual aneurysms but did not provide definitive treatment in any of our patients.
Authors:
L Fernando Gonzalez; Michael J Alexander; Cameron G McDougall; Robert F Spetzler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  55     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-28     Completed Date:  2005-06-28     Revised Date:  2006-05-31    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1025-35     Citation Subset:  IM    
Affiliation:
Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Angiography / methods
Arteries / surgery*
Brain Stem / blood supply,  pathology
Cerebellar Cortex / blood supply*,  surgery*
Cerebellar Diseases / surgery
Child
Female
Humans
Intracranial Aneurysm / surgery*
Male
Middle Aged
Neurosurgery / methods
Retrospective Studies
Vascular Surgical Procedures / methods
Comments/Corrections
Comment In:
Neurosurgery. 2005 Sep;57(3):E601; author reply E601   [PMID:  16145515 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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