{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:29:38Z","timestamp":1790850578699,"version":"4.1.0"},"reference-count":128,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:p>Aneurysms of the anterior inferior cerebellar artery (AICA) are relatively rare among intracranial aneurysms. They can occur in 1 of 3 regions of the AICA: 1) craniocaudal (high or low riding), 2) mediolateral-premeatal (proximal), and 3) meatal-postmeatal (distal). The management strategies for treatment differ according to the location and configuration of the aneurysm. The existing body of neurosurgical literature contains articles published on aneurysms arising from the AICA near the basilar artery (BA), intracanalicular\/meatal aneurysms, and distal AICA. Several therapeutic options exist, encompassing microsurgical and endovascular techniques. The authors describe a case of treatment involving a large BA-AICA aneurysm approached via exposure of the presigmoid dura using a retromastoid suboccipital craniectomy and partial petrosectomy. Treatment of these lesions requires detailed knowledge of the anatomy, and an anatomical overview of the AICA with its arterial loops and significant branches is presented, including a discussion of the internal auditory (labyrinthine) artery, recurrent perforating arteries, subarcuate artery, and cerebellosubarcuate artery. The authors discuss the various surgical approaches (retromastoid, far lateral, subtemporal, and transclival) with appropriate illustrations, citing the advantages and disadvantages in accessing these AICA lesions in relation to these approaches. The complications of these different surgical techniques and possible clinical effects of parent artery occlusion during AICA surgery are highlighted.<\/jats:p>","DOI":"10.3171\/2009.1.focus0915","type":"journal-article","created":{"date-parts":[[2009,5,1]],"date-time":"2009-05-01T09:57:26Z","timestamp":1241171846000},"page":"E6","source":"Crossref","is-referenced-by-count":51,"title":["Management of anterior inferior cerebellar artery aneurysms: an illustrative case and review of literature"],"prefix":"10.3171","volume":"26","author":[{"given":"Nicholas C.","family":"Bambakidis","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University Hospitals Case Medical Center, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Manjila","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University Hospitals Case Medical Center, Cleveland, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shervin","family":"Dashti","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Tarr","sequence":"additional","affiliation":[{"name":"Departments of Neuroradiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cliff A.","family":"Megerian","sequence":"additional","affiliation":[{"name":"Otolaryngology\u2013Head and Neck Surgery, University Hospitals Case Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0260006","series-title":"Arch Neurol Psychiatry","first-page":"765","article-title":"Occlusion of the anterior inferior cerebellar artery","volume":"49","author":"Adams","year":"1943"},{"key":"b2-0260006","series-title":"J Neurosurg","first-page":"97","article-title":"Microvascular anatomy of the anterior surface of the medulla oblongata and olive","volume":"82","author":"Akar","year":"1995"},{"key":"b3-0260006","series-title":"Stroke","first-page":"105","article-title":"Causes and mechanisms of territorial and nonterritorial cerebellar infarcts in 115 consecutive patients","volume":"25","author":"Amarenco","year":"1994"},{"key":"b4-0260006","series-title":"Acta Neurochir (Wien)","first-page":"419","article-title":"Multiple, peripheral aneurysms of the anterior inferior cerebellar artery","volume":"147","author":"Andaluz","year":"2005"},{"key":"b5-0260006","series-title":"Operative Neurosurgery","first-page":"202","article-title":"The evolution of surgical approaches in the treatment of petroclival meningiomas: a single-center retrospective review","volume":"61","author":"Bambakidis","year":"2007"},{"key":"b6-0260006","series-title":"Surgery of the Cerebellopontine Angle","article-title":"Combined surgical approaches","author":"Bambakidis","year":"2009"},{"key":"b7-0260006","series-title":"J Neurosurg","first-page":"859","article-title":"Unruptured intracranial aneurysms and arteriovenous malformations: frequency of intracranial hemorrhage and relationship of lesions","volume":"73","author":"Brown","year":"1990"},{"key":"b8-0260006","series-title":"Neurosurgery","article-title":"Quantitative comparison of Kawase's approach versus the retrosigmoid approach: implications for tumors involving both the middle and posterior fossae","author":"Chang","year":"2009"},{"key":"b9-0260006","series-title":"Stereotact Funct Neurosurg","first-page":"190","article-title":"Microvascular decompression for hemifacial spasm: a long-term follow-up of 1,169 consecutive cases","volume":"77","author":"Chung","year":"2001"},{"key":"b10-0260006","series-title":"J Neurosurg","first-page":"483","article-title":"Transoral transclival clipping of anterior interior cerebellar artery aneurysm using new rotating applier. 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report","volume":"79","author":"Hansen","year":"1970"},{"key":"b24-0260006","series-title":"Diagnostic Imaging: Brain","first-page":"24","article-title":"Vascular loop compression, CPA-IAC","author":"Harnsberger","year":"2004"},{"key":"b25-0260006","series-title":"Surg Neurol","first-page":"455","article-title":"Treatment of giant fusiform aneurysms of the basilar trunk with intra-aneurysmal and basilar artery coil embolization","volume":"62","author":"Hassan","year":"2004"},{"key":"b26-0260006","series-title":"Neurosurg Psychiatry","first-page":"446","article-title":"Transoral-transclival clipping of a midline vertebral artery aneurysm","volume":"46","author":"Hitchcock","year":"1983"},{"key":"b27-0260006","series-title":"Clin Imaging","first-page":"77","article-title":"Value of CT angiography in the evaluation of a peripheral anterior inferior cerebellar artery aneurysm: case 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Sci","first-page":"130","article-title":"Cerebral arteriovenous malformations with hassociated arterial aneurysm: hemodynamic and therapeutic considerations","volume":"15","author":"Kondziolka","year":"1988"},{"key":"b33-0260006","series-title":"Acta Neurochir (Wien)","first-page":"29","article-title":"Cerebral arteriovenous malformations (C. 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Case report","volume":"74","author":"Linskey","year":"1991"},{"key":"b36-0260006","series-title":"AJNR Am J Neuroradiol","first-page":"1208","article-title":"Endovascular treatment of peripheral cerebellar artery aneurysms","volume":"24","author":"Lubicz","year":"2003"},{"key":"b37-0260006","series-title":"J Clin Neurosci","first-page":"207","article-title":"Aneurysm of the anterior inferior cerebellar artery (AICA) associated with high-flow lesion: report of two cases and review of literature","volume":"9","author":"Menovsky","year":"2002"},{"key":"b38-0260006","series-title":"Neurol Med Chir (Tokyo)","first-page":"406","article-title":"Hemifacial spasm caused by CP angle AVM associated with ruptured aneurysm in the feeding artery: case report","volume":"31","author":"Nagata","year":"1991"},{"key":"b39-0260006","series-title":"J Neurosurg","first-page":"697","article-title":"Anterior interior cerebellar artery aneurysm. Report of three cases","volume":"59","author":"Nishimoto","year":"1983"},{"key":"b40-0260006","series-title":"Neurosurgery","first-page":"190","article-title":"Aneurysmal expansion presenting as facial weakness: case report and review of the literature","volume":"56","author":"Neimat","year":"2005"},{"key":"b41-0260006","series-title":"Neurosurgery","first-page":"736","article-title":"Transfacial transclival approach for midline posterior circulation aneurysms","volume":"39","author":"Ogilvy","year":"1996"},{"key":"b42-0260006","series-title":"Neurol Med Chir (Tokyo)","first-page":"161","article-title":"Intrameatal aneurysm successfully treated by meatal loop trapping: case report","volume":"39","author":"Okumura","year":"1999"},{"key":"b43-0260006","series-title":"J Clin Neurosci","first-page":"324","article-title":"A giant fusiform basilar aneurysm treated by bilateral vertebral artery occlusion","volume":"11","author":"Omahen","year":"2004"},{"key":"b44-0260006","series-title":"J Neurosurg","first-page":"631","article-title":"Feeding artery pedicle aneurysms: association with parenchymal hemorrhage and arteriovenous malformation in the brain","volume":"80","author":"Perata","year":"1994"},{"key":"b45-0260006","series-title":"J Neurosurg","first-page":"539","article-title":"Arterial aneurysms associated with cerebral arteriovenous malformations: classification, incidence, and risk of hemorrhage","volume":"89","author":"Redekop","year":"1998"},{"key":"b46-0260006","series-title":"Rhoton's Anatomy: Cranial Anatomy and Surgical Approaches","first-page":"461","article-title":"The cerebellar arteries","author":"Rhoton","year":"2003"},{"key":"b47-0260006","series-title":"Neurosurgery","first-page":"1147","article-title":"Endovascular treatment of distally located giant aneurysms","volume":"47","author":"Ross","year":"2000"},{"key":"b48-0260006","series-title":"No Shinkei Geka","first-page":"269","article-title":"An arterial dissection of the distal anterior inferior cerebellar artery treated by endovascular therapy","volume":"28","author":"Saito","year":"2000"},{"key":"b49-0260006","series-title":"Neurol Med Chir (Tokyo)","first-page":"753","article-title":"Clipping of vertebrobasilar aneurysms by the transoral transclival approach","volume":"20","author":"Saito","year":"1980"},{"key":"b50-0260006","series-title":"No Shinkei Geka","first-page":"709","article-title":"Distal anterior inferior cerebellar artery aneurysms: report of three cases and literature review","volume":"29","author":"Saito","year":"2001"},{"key":"b51-0260006","series-title":"Skull Base","first-page":"101","article-title":"Distal anterior inferior cerrebellar artery aneurysm masquerading as a cerebellopontine angle tumor: case report and review of literature","volume":"14","author":"Sarkar","year":"2004"},{"key":"b52-0260006","series-title":"Neurol Med Chir (Tokyo)","first-page":"86","article-title":"Direct surgery of basilar trunk and vertebrobasilar junction aneurysms via the combined transpetrosal approach","volume":"38","author":"Seifert","year":"1998"},{"key":"b53-0260006","series-title":"J Neurosurg","first-page":"373","article-title":"Posterior transpetrosal approach to aneurysms of the basilar trunk and vertebrobasilar junction","volume":"85","author":"Seifert","year":"1996"},{"key":"b54-0260006","series-title":"AJNR Am J Neuroradiol","first-page":"257","article-title":"Coiling of very large or giant cerebral aneurysms: long-term clinical and serial angiographic results","volume":"24","author":"Sluzewski","year":"2003"},{"key":"b55-0260006","series-title":"J Neurosurg","first-page":"868","article-title":"Aneurysms of the basilar artery treated with circulatory arrest, hypothermia, and barbiturate cerebral protection","volume":"68","author":"Spetzler","year":"1988"},{"key":"b56-0260006","series-title":"Otolaryngol Clin North Am","first-page":"367","article-title":"Transpetrosal surgery techniques","volume":"35","author":"Steward","year":"2002"},{"key":"b57-0260006","series-title":"Surg Neurol","first-page":"509","article-title":"Embolization of a ruptured aneurysm of the distal anterior inferior cerebellar artery: case report and review of the literature","volume":"51","author":"Suzuki","year":"1999"},{"key":"b58-0260006","series-title":"Neurosurgery","first-page":"1083","article-title":"Basilar trunk aneurysm surgically treated with anterior petrosectomy and external carotid artery-to-posterior cerebral artery bypass: technical note","volume":"51","author":"Tersaka","year":"2002"},{"issue":"2","key":"b59-0260006","series-title":"Neurosurg Focus","first-page":"E6","article-title":"Transpetrosal approaches to the posterior fossa","volume":"19","author":"Tummala","year":"2005"},{"key":"b60-0260006","series-title":"J Neurosurg","first-page":"140","article-title":"Cervicomedullary junction compression caused by vertebral artery dolichoectasia and requiring surgical treatment. Case report","volume":"96","author":"Ubogu","year":"2002"},{"key":"b61-0260006","series-title":"Psychiatr Neurol Neurochir","first-page":"329","article-title":"Arterial and arteriovenous aneurysms of the posterior fossa","volume":"65","author":"Verbiest","year":"1962"},{"key":"b62-0260006","series-title":"Surg Neurol","first-page":"82","article-title":"Intracanalicular aneurysm at the meatal loop of the distal anterior inferior cerebellar artery: a case report and review of literature","volume":"61","author":"Yamakawa","year":"2004"},{"key":"b63-0260006","series-title":"J Neurosurg","first-page":"692","article-title":"Distal anterior inferior cerebellar aneurysms. Report of four cases","volume":"97","author":"Zager","year":"2002"},{"key":"b64-0260006","series-title":"Zhonghua Yi Xue Za Zhi","first-page":"1121","article-title":"Microvascular decompression for hemifacial spasm: experience of 215 cases","volume":"81","author":"Zhao","year":"2001"},{"key":"b1-0260006","series-title":"Arch Neurol Psychiatry","first-page":"765","article-title":"Occlusion of the anterior inferior cerebellar artery","volume":"49","author":"Adams","year":"1943"},{"key":"b2-0260006","series-title":"J Neurosurg","first-page":"97","article-title":"Microvascular anatomy of the anterior surface of the medulla oblongata and olive","volume":"82","author":"Akar","year":"1995"},{"key":"b3-0260006","series-title":"Stroke","first-page":"105","article-title":"Causes and mechanisms of territorial and nonterritorial cerebellar infarcts in 115 consecutive patients","volume":"25","author":"Amarenco","year":"1994"},{"key":"b4-0260006","series-title":"Acta Neurochir (Wien)","first-page":"419","article-title":"Multiple, peripheral aneurysms of the anterior inferior cerebellar artery","volume":"147","author":"Andaluz","year":"2005"},{"key":"b5-0260006","series-title":"Operative Neurosurgery","first-page":"202","article-title":"The evolution of surgical approaches in the treatment of petroclival meningiomas: a single-center retrospective review","volume":"61","author":"Bambakidis","year":"2007"},{"key":"b6-0260006","series-title":"Surgery of the Cerebellopontine Angle","article-title":"Combined surgical approaches","author":"Bambakidis","year":"2009"},{"key":"b7-0260006","series-title":"J Neurosurg","first-page":"859","article-title":"Unruptured intracranial aneurysms and arteriovenous malformations: frequency of intracranial hemorrhage and relationship of lesions","volume":"73","author":"Brown","year":"1990"},{"key":"b8-0260006","series-title":"Neurosurgery","article-title":"Quantitative comparison of Kawase's approach versus the retrosigmoid approach: implications for tumors involving both the middle and posterior fossae","author":"Chang","year":"2009"},{"key":"b9-0260006","series-title":"Stereotact Funct Neurosurg","first-page":"190","article-title":"Microvascular decompression for hemifacial spasm: a long-term follow-up of 1,169 consecutive cases","volume":"77","author":"Chung","year":"2001"},{"key":"b10-0260006","series-title":"J Neurosurg","first-page":"483","article-title":"Transoral transclival clipping of anterior interior cerebellar artery aneurysm using new rotating applier. Technical note","volume":"75","author":"Crockard","year":"1991"},{"key":"b11-0260006","series-title":"Surgery of the Cerebellopontine Angle","article-title":"Vascular lesions of the cerebellopontine angle","author":"Dashti","year":"2009"},{"key":"b12-0260006","series-title":"Surg Neurol","first-page":"379","article-title":"Transoral-transclival clipping of a giant lower basilar artery aneurysm","volume":"38","author":"de Ios Reyes","year":"1992"},{"key":"b13-0260006","series-title":"J Neurosurg","first-page":"1","article-title":"Posterior fossa arteriovenous malformations","volume":"64","author":"Drake","year":"1986"},{"key":"b14-0260006","series-title":"Surgery of Vertebrobasilar Aneurysms: London, Ontario Experience on 1767 Patients","author":"Drake","year":"1996"},{"key":"b15-0260006","series-title":"AJNR Am J Neuroradiol","first-page":"137","article-title":"Coil occlusion of the parent artery for treatment of symptomatic peripheral intracranial aneurysms","volume":"21","author":"Eckard","year":"2000"},{"key":"b16-0260006","series-title":"Disorders of the Skull Base Region Proceedings","first-page":"121","article-title":"The surgical anatomy of the so-called internal auditory artery","author":"Fisch","year":"1969"},{"key":"b17-0260006","series-title":"Neurosurg Psychiatry","first-page":"237","article-title":"Angiographic ending of an aneurysm and arteriovenous malformation in the posterior cranial fossa in a case of subarachnoid hemorrhage","volume":"23","author":"Gibson","year":"1960"},{"key":"b18-0260006","series-title":"Neurosurgery","first-page":"1025","article-title":"Anterioinferior cerebellar artery aneurysms: surgical approaches and outcomes: a review of 34 cases","volume":"55","author":"Gonzalez","year":"2004"},{"key":"b19-0260006","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Skull base approaches to the basilar artery","volume":"19","author":"Gonzalez","year":"2005"},{"issue":"2","key":"b20-0260006","series-title":"Neurol Res","first-page":"296","article-title":"Delayed effects of the microvascular decompression on hemifacial spasm: a retrospective study of 131 consecutive operated cases","volume":"24","author":"Goto","year":"2002"},{"key":"b21-0260006","series-title":"Neurosurgery","first-page":"793","article-title":"Clinical and angiographic results of endovascular coiling treatment of giant and very large intracranial aneurysms: a 7-year, single-center experience","volume":"45","author":"Gruber","year":"1999"},{"key":"b22-0260006","series-title":"Neuroradiology","first-page":"535","article-title":"Spontaneous dissection of the anterior inferior cerebellar artery","volume":"42","author":"Hancock","year":"2000"},{"key":"b23-0260006","series-title":"Ann Otol Rhinol Laryngol","first-page":"269","article-title":"Vascular anatomy of the human temporal bone: a preliminary 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report","volume":"23","author":"Iwanaga","year":"1999"},{"key":"b28-0260006","series-title":"Neurosurgery","first-page":"1119","article-title":"Endoscope-assisted microsurgery for intracranial aneurysms","volume":"51","author":"Kalavakonda","year":"2002"},{"key":"b29-0260006","series-title":"J Neurosurg","first-page":"857","article-title":"Transpetrosal approach for aneurysms of the lower basilar artery","volume":"63","author":"Kawase","year":"1985"},{"key":"b30-0260006","series-title":"Neurol Med Chir (Tokyo)","first-page":"109","article-title":"Arteriovenous malformation in the cerebellopontine angle presenting as hemifacial spasm: case report","volume":"31","author":"Kim","year":"1991"},{"key":"b31-0260006","series-title":"Am J Otol","first-page":"386","article-title":"Uncommon lesions presenting as tumors of the internal auditory canal and cerebellopontine angle","volume":"18","author":"Kohna","year":"1997"},{"key":"b32-0260006","series-title":"Can J Neurol Sci","first-page":"130","article-title":"Cerebral arteriovenous malformations with hassociated arterial aneurysm: hemodynamic and therapeutic considerations","volume":"15","author":"Kondziolka","year":"1988"},{"key":"b33-0260006","series-title":"Acta Neurochir (Wien)","first-page":"29","article-title":"Cerebral arteriovenous malformations (C. 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