Ruptured intrameatal AICA aneurysms--a report of two cases and review of the literature.

Abstract

Aneurysms of the distal part of the anterior-inferior cerebellar artery (AICA) are rare. Most are located in the cerebellopontine angle close to the internal auditory meatus. To our knowledge, only 13 patients with the aneurysm located inside the internal auditory meatus have been reported in the literature. We present two cases of ruptured intrameatal AICA aneurysms that were treated in our center in the past year. The locations and clinical manifestations are discussed and all 13 previously published cases are reviewed. Exposure and decompression of all structures in the internal auditory meatus, careful manipulation of the nerves and vessels, temporary trapping of the aneurysm, and careful dissection of the neck to avoid partial clipping are the essential steps when treating intrameatal AICA aneurysms to reduce the risk of postoperative neurological deficits.