DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20210696

Clinical perspectives of anterior inferior cerebellar artery: a review

Santosh Kumar Swain, Prasenjit Baliarsingh

Abstract


The anterior inferior cerebellar artery arises at the cerebellopontine angle (CPA), usually from the lower one third of the basilar artery. However, the vascular anatomy of the anterior inferior cerebellar artery (AICA) is highly variable. In respect to the neurovascular relationship in the internal auditory canal (IAC), the AICA is intimately related with vestibulocochlear and facial nerve. Microvascular compression of the vestibulocochlear nerve by AICA is an important etiology for tinnitus, hearing loss and vertigo. The vascular loop or aneurysm of the AICA will compress the vestibulocochlear nerve in the internal auditory canal. The AICA loop should be separated from the vestibulocochlear nerve. Magnetic resonance angiography (MRA) is helpful to reveal the vascular pathology of the AICA and confirm the causes for disabling otological symptoms. After confirmation of the vascular pathology of AICA, surgery is usually planned. The intrameatal AICA and vestibulocochlear nerve conflict produce specific pathological features and their surgical treatment is also invariably challenging. The objective of this review article is to discuss the details of vascular anatomy, etiopathology, clinical presentations, diagnosis, neurophysiology and current treatment of the vascular anomalies of AICA in IAC which often pose challenge to the clinicians.


Keywords


Anterior inferior cerebellar artery, Vascular loop, Aneurysm, Microvascular decompression, Magnetic resonance imaging

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References


Hou K, Li G, Luan T, Xu K, Xu B, Yu J. Anatomical study of anterior inferior cerebellar artery and its reciprocal relationship with posterior inferior cerebellar artery based on angiographic data. World Neurosurg. 2020;133:459-72.

Swain SK, Sahu MC, Samal R, Padhy RN. Incidence of hearing loss, tinnitus and vertigo among Diabetes patients. Siriraj Med J. 2014;66:179-84.

Umehara F, Kamishima K, Kashio N, Yamaguchi K, Sakimoto T, Osame M. Magnetic resonance tomographic angiography: diagnostic value in trigeminal neuralgia. Neuroradiology. 1995;37:353-5.

Suzuki K, Meguro K, Wada M, Fujita K, Nose T. Embolization of a ruptured aneurysm of the distal anterior inferior cerebellar artery: Case report and review of the literature. Surg Neurol. 1999;51:509-12.

Borghei-Razavi H, Darvish O, Schick U. Disabling vertigo and tinnitus caused by intrameatal compression of the anterior inferior cerebellar artery on the vestibulocochlear nerve: a case report, surgical considerations, and review of the literature. J Neurol Surg Rep. 2014;75:47-51.

Markowski J, Gierek T, Kluczewska E, Witkowska M. Assessment of vestibulocochlear organ function in patients meeting radiologic criteria of vascular compression syndrome of vestibulocochlear nerve-diagnosis of disabling positional vertigo. Med Sci Monitor. 2011;17:169-73.

Mcdermott AL, Dutt SN, Irving RM, Pahor AL, Chavda SV. Anterior inferior cerebellar artery syndrome: fact or fiction. Clin Otolaryngol. 2003;28:75-80.

Jannetta PJ, Møller MB, Møller AR. Disabling positional vertigo. N Engl J Med. 1984;310(26):1700-5.

MøllerMB, Møller AR, Jannetta PJ, Jho HD, Sekhar LN. Microvascular decompression of the eighth nerve in patients with disabling positional vertigo: selection criteria and operative results in 207 patients. Acta Neurochir (Wien). 1993;125(1-4):75-82.

Matsuyama T, Okuchi K, Norimoto K, Ueyama T. Ruptured dissecting anterior inferior cerebellar artery aneurysm-Case report. Neurol Med Chir (Tokyo). 2002;42:214-6.

Lasjaunias P, Berenstein A, Brugge ter KG. Craniocervical junction. In: Clinical vascular anatomy and variations. Berlin, Heidelberg: Springer. 2001;165-260.

Akar ZC, Dujovny M, Gomez-Tortosa E, Slavin KV, Ausman JI. Microvascular anatomy of the anterior surface of the medulla oblongata and olive. J Neurosurg. 1995;82:97-105.

Peluso JP, van Rooij WJ, Sluzewski M, Beute GN. Distal aneurysms of cerebellar arteries: Incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. Am J Neuroradiol. 2007;28:1573-8.

Peluso JP, van Rooij WJ, Sluzewski M, Beute GN. Distal aneurysms of cerebellar arteries: Incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. Am J Neuroradiol. 2007;28:1573-8.

Sekhar LN, Schessel DA, Bucur SD, Raso JL, Wright DC. Partial labyrinthectomy petrous apicectomy approach to neoplastic and vascular lesions in petroclival area. Neurosurg. 1999;44:550-2.

Zhang L, Yu Y, Yuan Y, Xu J, Xu X, Zhang J. Microvascular decompression of cochleovestibular nerve in patients with tinnitus and vertigo. Neurology India. 2012;60(5):495.

Applebaum EL, Valvasorri G. Internal auditory canal vascular loops: audiometric and vestibular system findings. Am J Otol. 1985;110-3.

Jannetta PJ. Neurovascular cross-compression in patients with hyperactive dysfunction symptoms of the eighth cranial nerve. Surg Forum. 1975;26:467-9.

Suzuki J, Hori S, Sakurai Y. Intracranial aneurysms in the neurosurgical clinics in Japan. J Neurosurg. 1971;35:34-9.

Yamakawa H, Hattori T, Tanigawara T, Sahashi Y, Ohkuma A: Intracanalicular aneurysm at the meatal loop of the distal anterior inferior cerebellar artery: a case report and review of literature. Surg Neurol. 2004;61:82-8.

Mitsos AP, Corkill RA, Lalloo S, Kuker W, Byrne JV. Idiopathic aneurysms of distal cerebellar arteries: Endovascular treatment after rupture. Neuroradiology. 2008;50:161-70.

Swain SK, Nayak S, Ravan JR, Sahu MC. Tinnitus and its current treatment-Still an enigma in medicine. J Formosan Med Assoc. 2016;115(3):139-44.

Swain SK. Age related hearing loss and cognitive impairment-a current perspective. Int J Res Med Sci. 2021;9(1):317-21.

Swain SK, Sahu MC, Choudhury J. Sudden sensorineural hearing loss in children: Our experiences in tertiary care teaching hospital of eastern India. Pediatria Polska-Polish J Paediatr.2018;93(2):127-31.

De Ridder D, De Ridder L, Nowé V, Thierens H, Van de Heyning P, Møller A. Pulsatile tinnitus and the intrameatal vascular loop: why do we not hear our carotids? Neurosurgery. 2005;57:1213-7.

Swain SK, Sahu MC, Choudhury J. Sudden sensorineural hearing loss in children: Our experiences in tertiary care teaching hospital of eastern India. Pediatria Polska-Polish J Paediatr.2018;93(2):127-31.

Swain SK, Behera IC, Sahu MC. Tinnitus among children-Our experiences in a tertiary care teaching hospital of eastern India. Pediatria Polska. 2017;92(5):513-7.

Zager EL, Shaver EG, Hurst RW, Flamm ES. Distal anterior inferior cerebellar artery aneurysms. Report of four cases. J Neurosurg. 2002;97:692-6.

Peluso JP, van Rooij WJ, Sluzewski M, Beute GN. Distal aneurysms of cerebellar arteries: Incidence, clinical presentation, and outcome of endovascular parent vessel occlusion. Am J Neuroradiol. 2007;28:1573-8.

Kania RE, Herman P, Lot G, Huy PT. Ipsilateral beating nystagmus after acoustic schwannoma resection. Auris Nasus Larynx. 2004;31:69-72.

Adams RD. Occlusion of the anterior inferior cerebellar artery. Archives of Neurology and Psychiatry. 1943;49:765-70.

Lee H, Ahn BH, Baloh RW. Sudden deafness with vertigo as a sole manifestation of anterior inferior cerebellar infarction. J Neurol Sci. 2004;222:105-7.

Oas JG, Baloh RW. Vertigo and the anterior inferior cerebellar artery syndrome. Neurology. 1992;42:2274-9.

Borghei-Razavi H, Darvish O, Schick U. Disabling Vertigo and Tinnitus Caused by Intrameatal Compression of the Anterior Inferior Cerebellar Artery on the Vestibulocochlear Nerve: A Case Report, Surgical Considerations, and Review of the Literature. J Neurol Surg Rep. 2014;75:47-51.

Parnes LS, Shimotakahara SG, Pelz D, Lee D, Fox AJ. Vascular relationships of the vestibulocochlear nerve on magnetic resonance imaging. Am J Otol. 1990;11:278-81.

Wuertenberger CJ, Rosahl SK. Vertigo and tinnitus caused by vascular compression of the vestibulocochlear nerve, not intracanalicular vestibular schwannoma: review and case presentation. Skull Base. 2009;19(6):417-24.

Makins AE, Nikolopoulos TP, Ludman C, O’Donoghue GM. Is there a correlation between vascular loops and unilateral auditory symptoms? Laryngoscope. 1998;108(11):1739-42.

Sahoo L, Swain SK, Das A, Nahak B, Munjal S. Clinical concerns of hearing loss in old age: an Indian perspective. J Geriatr Care Res. 2020;7(2):56-63.

Moller MB. Results of microvascular decompression of the eighth nerve as treatment for disabling positional vertigo. Ann Otol Rhinol Laryngol. 1990;99:724-9.

Chadha NK, Weiner GM. Vascular loops causing otological symptoms: a systematic review and meta-analysis. Clin Otolaryngol. 2008;33:5-11.

LeeH, Sohn SI, Jung DK, et al. Sudden deafness and anterior inferior cerebellar artery infarction. 2002;33(12):2807-12.

Lubicz B, Leclerc X, Gauvrit JY, Lejeune JP, Pruvo JP. Endovascular treatment of peripheral cerebellar artery aneurysms. Am J Neuroradiol. 2003;24:1208-13.

Gonzalez LF, Alexander MJ, McDougall CG, Spetzler RF. Anteroinferior cerebellar artery aneurysms: surgical approaches and outcomes—a review of 34 cases. Neurosurgery. 2004;5:1025-35.