Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-25T01:12:19.695Z Has data issue: false hasContentIssue false
  • English
  • Français

Distal Mycotic Aneurysm of the AICA Mimicking Intracanalicular Acoustic Neuroma

Published online by Cambridge University Press:  02 December 2014

Salvatore DiMaio ,
Gérard Mohr ,
Jean-Jacques Dufour  and
Steffan Albrecht
Salvatore DiMaio
Affiliation:
Division of Neurosurgery, Sir Mortimer B. Davis – Jewish General Hospital, McGill University, Montreal, QC, Canada
Gérard Mohr
Affiliation:
Division of Neurosurgery, Sir Mortimer B. Davis – Jewish General Hospital, McGill University, Montreal, QC, Canada
Jean-Jacques Dufour
Affiliation:
Otolaryngology, Sir Mortimer B. Davis – Jewish General Hospital, McGill University, Montreal, QC, Canada
Steffan Albrecht
Affiliation:
Pathology, Sir Mortimer B. Davis – Jewish General Hospital, McGill University, Montreal, QC, Canada
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Among cases of cerebellopontine angle lesions, vascular lesions involving the internal auditory canal are extremely rare. We report a distal fusiform mycotic pseudoaneurysm of the anterior inferior cerebellar artery (AICA) that simulated an acoustic neuroma on presentation.

Methods:

A 60-year-old woman was investigated for recent onset of acute dizziness. Laboratory and radiographic investigations are presented, as well as the surgical management of the patient and pathological examination of the aneurysm.

Conclusion:

An exceptionally rare case of distal mycotic intracanalicular pseudoaneurysm of the AICA with intraluminal thrombus and fusiform anatomy is described. In our review of the literature (1966-present), only five other intracanalicular AICA-aneurysms were encountered, none of which were infectious in etiology. The possible pathophysiologic mechanisms of distal AICA-aneurysms are discussed along with the currently available literature.

Résumé:

RÉSUMÉ: Introduction:

Parmi les cas de lésions de l'angle ponto-cérébelleux, les lésions vasculaires impliquant le canal auditif interne (CM) sont extrêmement rares. Nous rapportons un cas de pseudo-anévrisme mycotique fusiforme de l'artère cérébelleuse inférieure et antérieure (ACIA) dont le mode de présentation simulait un neurinome acoustique.

Méthodes:

Une femme âgée de 60 ans a été examinée pour un état vertigineux aigu d'apparition récente. Nous présentons les résultats des examens biochimiques et de radiologiques ainsi que le traitement chirurgical de la patiente et l'examen anatomopathologique de l'anévrisme.

Conclusions:

Nous décrivons un cas extrêmement rare de pseudo-anévrisme intracanaliculaire mycotique fusiforme de l'ACIA distale avec thrombus intraluminal. Selon notre revue de la littérature de 1966 à nos jours, seulement cinq autres anévrismes intracanaliculaires de l'ACIA ont été rapportés et aucun d'eux n'était d'étiologie infectieuse. Nous discutons des mécanismes physiopathologiques possibles des anévrismes de l'ACIA distale et de la littérature sur le sujet.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 30 , Issue 4 , November 2003 , pp. 388 - 392
Copyright
Copyright © The Canadian Journal of Neurological 2003

References

1. Kamano, S, Kirino, T, Mizuno, S. Intrameatal aneurysm. Neurochirurgia 1986;29:28–30.Google Scholar
2. Inoue, Y, Morinaga, K, Matsumoto, Y, et al. A case of ruptured internal auditory meatus aneurysm. Surg Cerebr Str 1987;15:280–284.Google Scholar
3. Okumura, Y, Sakaki, T, Hirabayashi, H, et al. Intrameatal aneurysm successfully treated be meatal loop trapping—case report. Neurol Med Chir 1999;39:161–164.CrossRefGoogle ScholarPubMed
4. Spallone, A, De Santis, S, Giuffre, R. Peripheral aneurysms of the distal anterior inferior cerebellar artery. Case report and review of literature. Br J Neurosurg 1995;9:537–541.CrossRefGoogle ScholarPubMed
5. Hayes, WT, Bernhardt, H, Young, JM. Fusiform arteriosclerotic aneurysm of the basilar artery. Vasc Surg 1967;1:171–178.Google Scholar
6. Bohrer, PS, Chole, RA. Unusual lesions of the internal auditory canal. Am J Otol 1996;17:143–149.Google Scholar
7. Browning, S, Mohr, G, Dufour, JJ, et al. Hearing preservation in acoustic neuroma surgery. J Otolaryngol 2001;30:307–315.Google Scholar
8. Dufour, JJ, Michaud, LA, Mohr, G, et al. Intratemporal vascular malformations (angioma):particular clinical features. J Otolaryngol 1994;23:250–253.Google Scholar
9. Mohr, G, Dufour, JJ, Zeitouni, A, Rappaport, J, Browning, S. Oto-neurosurgical management of cerebellopontine angle lesions: the suboccipital approach revisited. In: Sanna, M, Taibah, A, Russo, A, Mancini, F (Eds). S.P.A. Acoustic Neurinoma and Other CPA Tumors. Rome: Monduzzi Editore 1999;6-12:303–314.Google Scholar
10. Hori, T, Hirakawa, K, Ishijima, B, et al. Aneurysm in the internal auditory meatus. Case report. J Neurosurg 1971;35:605–609.Google Scholar
11. Maeta, M, Saito, R, Nameka, H. False-positive magnetic resonance image in the diagnosis of small acoustic neuroma. J Laryngol Otol 2001;115:842–844.Google Scholar
12. Cantore, GP, Ciapetta, P, Vagnozzi, R, et al. Giant aneurysm of the anterior inferior cerebellar artery simulating a cerebellopontine angle tumor. Surg Neurol 1982;18:76–78.Google Scholar
13. Dalley, RW, Robertson, WD, Nugent, RA, et al. Computed tomography of anterior inferior cerebellar artery aneurysm mimicking an acoustic neuroma. J Comput Assist Tomogr 1986;10:881–884.Google Scholar
14. Zager, EL, Shaver, EG, Hurst, RW, et al. Distal anterior inferior cerebellar artery aneurysms: report of four cases. J Neurosurg 2002;97:692–696.Google Scholar
15. Gleeson, MJ, Cox, TC, Strong, AJ. Aneurysm of the anterior inferior cerebellar artery mimicking an intracanalicular acoustic neuroma. J Laryngol Otol 1989;103:107–110.Google Scholar
16. Bradley, WG. MR appearance of hemorrhage in the brain. Radiology 1993;189:15–26.Google Scholar
17. Findlay, JM, Hao, C, Emery, D. Non-atherosclerotic fusiform cerebral aneurysms. Can J Neurol Sci 2002;29:41–48.Google Scholar
18. Nakatomi, H, Segawa, H, Kurata, A, et al. Clinicopathological study of intracranial fusiform and dolichoectatic aneurysms. Insights on the mechanism of growth. Stroke 2000;31:896–900.Google Scholar
19. Vale, F, Hadley, MN. Pathology of intracranial aneurysms and vascular malformations. In: Batjer, HH (Ed). Cerebrovascular Disease. Philadelphia: Lippincott-Raven, 1997:65–77.Google Scholar
20. Kato, N, Ezura, M, Takahashi, A, et al. Intraaneurysmal embolization and parent artery trapping to treat a giant partial thrombosed vertebral artery aneurysm after surgical proximal clipping. Neurol Surg 2000;28:817–822.Google Scholar
21. Sagoh, M, Hirose, Y, Murakami, H, et al. Late hemorrhage from persistent pseudoaneurysm in vertebral artery dissection presenting with ischemia: case report. Surg Neurol 1999;52:480–483.Google Scholar
22. Orita, T, Kajiwara, K, Izumihara, A. Ruptured aneurysm at the peripheral branch of the posterior cerebral artery with systemic lupus erythematous. No To Shinkei 1992;44:733–737.Google Scholar
23. Schievink, WI, Parisi, JE, Piepgras, DG, et al. Intracranial aneurysms in Marfan's syndrome: an autopsy study. Neurosurgery 1997;41:866–870.CrossRefGoogle ScholarPubMed
24. Ide, Y, Wakuta, Y, Orita, T, et al. A case of iatrogenic traumatic intracranial aneurysm. Neurol Surg 1987;15:1353–1359.Google Scholar
25. Johnston, SC, Halbach, VV, Smith, WS, et al. Rapid development of giant fusiform cerebral aneurysms in angiographically normal vessels. Neurology 1998;50:1163–1166.CrossRefGoogle ScholarPubMed
26. Moriyama, T, Shigemori, M, Hirohata, Y, et al. Multiple intracranial aneurysms following radiation therapy for pituitary adenoma; a case report. Neurol Surg 1992;20:487–492.Google Scholar
27. Tan, MP, McConachie, NS, Vloeberghs, M. Ruptured fusiform cerebral aneurysm in a neonate. Childs Nerv Syst 1998;14:467–469.Google Scholar
28. Wakabayashi, Y, Nakano, T, Isono, M, et al. Dissecting aneurysm of the anterior cerebral artery requiring surgical treatment--case report. Neurol Med Chir 2000;40:624–627.Google Scholar
29. Barker, DL, Prats, AR. Mycotic aneurysms. Ann Surg 1954;139:84.Google Scholar
30. Clare, CE, Barow, DL. Infectious intracranial aneurysms. Neurosurg Clin N Am 1992;3:551–566.Google Scholar
31. Tunkel, AR, Kaye, D. The neurologic complications of infective endocarditis. Neurol Clin 1993;11:419.Google Scholar
32. Nader, R, Mohr, G, Sheiner, NM, et al. Mycotic aneurysm of the carotid bifurcation in the neck: case report and review of the literature. Neurosurgery 2001;48:1152–1156.Google Scholar
33. Sinclair, D, Mohr, G. Cerebral vasculitis. In: Aminoff, M, Daroff, R. Encyclopedia of the Neurological Sciences. San Diego: Academic Press. b. Ref Type: 2003. In Press.Google Scholar