Anterior Inferior Cerebellar Artery Aneurysm: Saccular Non-ruptured Aneurysm of the Premeatal Segment of the Anterior Inferior Cerebellar Artery, Treated with Flow Diverter Implantation into the Basilar Artery, with Complete Aneurysm Occlusion, Preservation of the Parent Artery, and Good Clinical Outcome

  • Rene Viso
  • Ivan Lylyk
  • Javier Lundquist
  • Pedro LylykEmail author
Living reference work entry


A 43-year-old female patient who presented with hearing loss was found to have a small saccular aneurysm of the left anterior inferior cerebellar artery (AICA) arising at its origin from the basilar artery (BA). The aneurysm was treated with endovascular implantation of a Pipeline Embolization Device (PED) flow diverter into the BA, jailing the origin of the AICA and thus reducing the inflow into the aneurysm sac. The postoperative course was uneventful and the hearing loss remained stable. Angiographic follow-up examinations at 6 and 12 months confirmed complete occlusion of the aneurysm. Implantation of a flow diverter into the BA appears to be a viable option in the treatment of proximal AICA aneurysms, as conventional deconstructive techniques in the treatment of these aneurysms can cause severe neurologic deficit. Flow diversion is also technically more straightforward than stent- or balloon-assisted coil occlusion. The various technical options for the treatment of AICA aneurysms are the main topic of this chapter.


Anterior inferior cerebellar artery (AICA) Flow diverter Posterior fossa aneurysm Pipeline Embolization Device (PED) Slipstream effect 


  1. Bambakidis NC, Manjila S, Dashti S, Tarr R, Megerian CA. Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature. Neurosurg Focus. 2009;26(5):E6. Scholar
  2. Bhogal P, Chudyk J, Bleise C, Lylyk I, Henkes H, Lylyk P. The use of flow diverters to treat aneurysms of the posterior inferior cerebellar artery: report of three cases. Interv Neuroradiol. 2018;24(5):489–98. Scholar
  3. Kanamori F, Kawabata T, Muraoka S, Kojima T, Watanabe T, Hatano N, Seki Y. Ruptured partially thrombosed anterior inferior cerebellar artery aneurysms: two case reports and review of literature. Nagoya J Med Sci. 2016;78(4):517–22. Scholar
  4. Kikkawa Y, Suzuki K, Teranishi A, Tachikawa T, Kurita H. Ruptured intrameatal anterior inferior cerebellar artery aneurysm associated with obstructed internal auditory artery in a patient with sudden hearing loss and vertigo. Acta Neurochir. 2018; Scholar
  5. Koizumi H, Kurata A, Suzuki S, Miyasaka Y, Tanaka C, Fujii K. Endosaccular embolization for a ruptured distal anterior inferior cerebellar artery aneurysm. Radiol Case Rep. 2015;7(2):651. Published 7 Dec 2015. Scholar
  6. Locksley HB. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. J Neurosurg. 1966;25(2):219–39. Scholar
  7. Lv X, Li Y, Liu A, Zhang J, Wu Z. Parent artery occlusion for peripheral anterior inferior cerebellar artery aneurysm. A case report and review of the literature. Neuroradiol J. 2008;21(2):261–5. Scholar
  8. Lv X, Ge H, He H, Jiang C, Li Y. Anterior inferior cerebellar artery aneurysms: segments and results of surgical and endovascular managements. Interv Neuroradiol. 2016;22(6):643–8. Scholar
  9. Mizushima H, Kobayashi N, Yoshiharu S, Kazuo H, Dohi K, Sasaki K, Matsumoto K. Aneurysm of the distal anterior inferior cerebellar artery at the medial branch: a case report and review of the literature. Surg Neurol. 1999;52(2):137–42.CrossRefGoogle Scholar
  10. Rhoton AL. The cerebellar arteries. In: Rhoton AL, editor. Rhoton’s cranial anatomy and surgical approaches. Philadelphia: Lippincott Williams and Wilkins; 2007. p. 476–83.Google Scholar
  11. Sarkar A, Link MJ. Distal anterior inferior cerebellar artery aneurysm masquerading as a cerebellopontine angle tumor: case report and review of literature. Skull Base. 2004;14(2):101–6. Discussion 106-7. Scholar
  12. Srinivasan VM, Ghali MGZ, Reznik OE, Cherian J, Mokin M, Dumont TM, Gaughen JR, Grandhi R, Puri AS, Chen SR, Johnson JN, Kan P. Flow diversion for the treatment of posterior inferior cerebellar artery aneurysms: a novel classification and strategies. J Neurointerv Surg. 2018;10(7):663–8. Scholar
  13. Suh SH, Kim DJ, Kim DI, Kim BM, Chung TS, Hong CK, Jung JY. Management of anterior inferior cerebellar artery aneurysms: endovascular treatment and clinical outcome. AJNR Am J Neuroradiol. 2011;32(1):159–64. Scholar
  14. Zager EL, Shaver EG, Hurst RW, Flamm ES. Distal anterior inferior cerebellar artery aneurysms. Rep Four Cases J Neurosurg. 2002;97(3):692–6. Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Rene Viso
    • 1
  • Ivan Lylyk
    • 1
  • Javier Lundquist
    • 1
  • Pedro Lylyk
    • 1
    Email author
  1. 1.Interventional NeuroradiologyClínica La Sagrada Familia, ENERIBuenos AiresArgentina

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