Distal anterior inferior cerebellar artery aneurysm masquerading as a cerebellopontine angle tumor: Case report and review of literature

Atom Sarkar, Michael J. Link

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

We present the case of a distal anterior inferior cerebellar artery (AICA) aneurysm masquerading as a cerebellopontine angle tumor in a 60-year-old right-handed man with previously undiagnosed polyarteritis nodosa (PAN). The patient presented with a 2-month history of progressive right-sided hearing loss, intermittent severe headache, and sudden onset of complete facial paralysis 3 weeks before admission. Magnetic resonance imaging, including postgadolinium images, showed a 1.2-cm heterogenously enhancing mass that slightly enlarged the right internal auditory canal. A right suboccipital. craniotomy was performed, and a partially thrombosed fusiform AICA aneurysm was discovered just anterior to the VII/VIII nerve complex. The aneurysm was trapped and opened, and a thrombectomy was performed. Postoperatively, the patient experienced abdominal pain; liver function tests were abnormal. Investigation revealed a small retroperitoneal hemorrhage and aneurysms of the celiac axis and gastroduodenal arteries. Further investigation revealed an increased erythrocyte sedimentation rate, and a diagnosis of PAN was made. PAN is a well-identified factor in the genesis of peripheral vascular aneurysms. Aneurysms involving the hepatic, renal, coronary, pancreatic, and tibial arteries have been described. PAN is an extremely rare cause of intracranial aneurysm. Patients who present with aneurysms in unusual locations (e.g., distal AICA) should be investigated for vasculopathy and collagen vascular disorders.

Original languageEnglish (US)
Pages (from-to)101-106
Number of pages6
JournalSkull Base
Volume14
Issue number2
DOIs
StatePublished - May 2004

Keywords

  • Aneurysm
  • Anterior inferior cerebellar artery
  • Peripheral vascular aneurysms
  • Polyarteritis nodosa

ASJC Scopus subject areas

  • Clinical Neurology

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