{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T17:44:18Z","timestamp":1696700658541},"reference-count":39,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>The coexistence of hyper-inflow aneurysms and cerebellopontine angle cistern (CPAc) arterial venous malformations (AVMs) have been rarely reported and most commonly associated with high risk of bleeding.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Descriptions: <\/jats:title>\n<jats:p>We present two cases of CPAc AVMs admitted for acute subarachnoid hemorrhage from rupture of a parent right pontine artery aneurysm. Admission history, neurology at presentation, pre\/post-operative imaging, approach selection, and results are thoroughly reviewed and presented. The acute origin angle of the vessel from the basilar artery made both malformations unsuitable for endovascular treatment. The surgical strategy was differently tailored in the two patients, respectively, using a Le Fort I\/transclival and a Kawase approach. The aneurysm was clipped in the first case, and the AVM was excised in the second one, as required by the anatomical context. Aneurysm exclusion and AVM size reduction were obtained in the first case, while complete AVM removal and later aneurysm disappearance were obtained in the second one. A high-flow cerebrospinal fluid leak in the first case was successfully treated by an endoscopic approach. Both patients experienced a satisfactory neurological outcome in the follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Pontine artery aneurysms, especially when associated with CPAc AVMs, represent a surgical challenge, due to their rarity and anatomical peculiarity, which typically requires complex operative approaches. Multimodal preoperative imaging, appropriate timing, and accurate target selection, together with versatile strategies, are the keys to a successful treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_246_2023","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T05:58:54Z","timestamp":1696571934000},"page":"352","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ruptured proximal pontine artery aneurysm and association with cerebellopontine angle cistern arterial venous malformation fed by the same artery: A surgical challenge"],"prefix":"10.25259","volume":"14","author":[{"given":"Maurizio","family":"Gladi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e0 Politecnica Delle Marche Facolt\u00e0 di Medicina e Chirurgia, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Di Rienzo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e0 Politecnica Delle Marche Facolt\u00e0 di Medicina e Chirurgia, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Rossella","family":"Fasinella","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e0 Politecnica Delle Marche Facolt\u00e0 di Medicina e Chirurgia, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Aiudi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e0 Politecnica Delle Marche Facolt\u00e0 di Medicina e Chirurgia, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Balercia","sequence":"additional","affiliation":[{"name":"Department of Maxillo-Facial Surgery, Ospedali Riuniti di Ancona, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Dobran","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e0 Politecnica Delle Marche Facolt\u00e0 di Medicina e Chirurgia, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Iacoangeli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e0 Politecnica delle Marche, Ancona, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,10,6]]},"reference":[{"key":"10.25259\/SNI_246_2023\/ref-1","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/2009.1.FOCUS0915","article-title":"Management of anterior inferior cerebellar artery aneurysms: An illustrative case and review of literature","volume":"26","author":"Bambakidis","year":"2009","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_246_2023\/ref-2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1227\/00006123-198601000-00006","article-title":"Intracranial arteriovenous malformations associated with aneurysms","volume":"18","author":"Batjer","year":"1986","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_246_2023\/ref-3","doi-asserted-by":"crossref","first-page":"751.e7","DOI":"10.1016\/j.wneu.2016.10.081","article-title":"Ruptured distal posterior inferior cerebellar artery (PICA) aneurysms associated with cerebellar arterial venous malformations (AVMs): A case series and review of the literature demonstrating the need for angiographic evaluation and feasibility of endovascular treatment","volume":"97","author":"Case","year":"2017","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_246_2023\/ref-4","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00006123-199802000-00001","article-title":"Endoscope-assisted brain surgery: Part 1--evolution, basic concept, and current technique","volume":"42","author":"Perneczky","year":"1998","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_246_2023\/ref-5","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3171\/jns.1991.75.3.0483","article-title":"Transoral transclival clipping of anterior inferior cerebellar artery aneurysm using new rotating applier. 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