scholarly journals Anterior inferior cerebellar artery vascular loop - type III

2021 ◽  
Author(s):  
Bahman Rasuli
2021 ◽  
Vol 18 (4) ◽  
Author(s):  
Murat Bayav ◽  
Murat Sahin

Background: Anatomical variations in vascular structures are frequently encountered. In the cerebellopontine region, anatomical variations, especially variations in the anterior inferior cerebellar artery (AICA) in relation to cranial nerves passing through the internal acoustic canal (IAC), are common. Magnetic resonance imaging (MRI) provides detailed information for the evaluation of the cerebellopontine region and the IAC anatomy. Objectives: This study aimed to examine the relationship between the IAC anatomy and AICA loop variations and to investigate the frequency of anatomical variations and its correlation with demographic variables. Patients and Methods: In this study, 253 patients (age > 18 years), who underwent 3-Tesla MRI of the temporal bone between July 2019 and December 2019, were retrospectively evaluated. The exclusion criteria were images of poor diagnostic quality due to technical or patient-related reasons and the presence of a localized tumor that could disrupt the IAC. Four patients were excluded from the study because they had tumors related to IAC. The AICA variations were categorized according to the Chavda classification. The IAC size, canal diameter, canal length, and meatus width were measured, and the canals were characterized as cylindrical, funnel-shaped, and bud-shaped. Results: A total of 249 patients were included in this study. The Chavda type I vascular loop was the most common type on both sides. The mean size measurements of IACs were significantly higher in the group of vascular loops compared to the group without vascular loops. The presence of a vascular loop was significantly more common in funnel- and bud-shaped IACs compared to cylindrical IAC. Also, there was a negative correlation between the patient’s age and all IAC dimensions. Conclusion: The results of the present study showed that the AICA loop variations were closely related to the size and shape of the IAC.


Author(s):  
Santosh Kumar Swain ◽  
Prasenjit Baliarsingh

<p class="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.</p>


2021 ◽  
pp. rapm-2020-102285
Author(s):  
Pascal SH Smulders ◽  
Michel AMB Terheggen ◽  
José W Geurts ◽  
Jan Willem Kallewaard

BackgroundTrigeminal neuralgia (TN) has the highest incidence of disorders causing facial pain. TN is provoked by benign stimuli, like shaving, leading to severe, short-lasting pain. Patients are initially treated using antiepileptic drugs; however, multiple invasive options are available when conservative treatment proves insufficient. Percutaneous radiofrequency treatment of the trigeminal, or gasserian, ganglion (RF-G) is a procedure regularly used in refractory patients with comorbidities. RF-G involves complex needle maneuvering to perform selective radiofrequency heat treatment of the affected divisions. We present a unique case of cranial nerve 4 (CN4) paralysis after RF-G.Case presentationA male patient in his 60s presented with sharp left-sided facial pain and was diagnosed with TN, attributed to the maxillary and mandibular divisions. MRI showed a vascular loop of the anterior inferior cerebellar artery without interference of the trigeminal complex. The patient opted for RF-G after inadequate conservative therapy. The procedure was performed by an experienced pain physician and guided by live fluoroscopy. The patient was discharged without problems but examined the following day for double vision. Postprocedural MRI showed enhanced signaling between the trigeminal complex and the brainstem. Palsy of CN4 was identified by a neurologist, and spontaneous recovery followed 5 months after the procedure.ConclusionsMention of postprocedural diplopia in guidelines is brief, and the exact incidence remains unknown. Different mechanisms for cranial nerve (CN) palsy have been postulated: incorrect technique, anatomical variations, and secondary heat injury. We observed postprocedural hemorrhage and hypothesized that bleeding might be a contributing factor in injury of CNs after RF-G.


1997 ◽  
Vol 117 (4) ◽  
pp. 308-314 ◽  
Author(s):  
J. Magnan ◽  
F. Caces ◽  
P. Locatelli ◽  
A. Chays

Sixty patients with primitive hemifacial spasm were treated by means of a minimally invasive retrosigmoid approach in which endoscopic and microsurgical procedures were combined. Intraoperative endoscopic examination of the cerebellopontine angle showed that for 56 of the patients vessel-nerve conflict was the cause of hemifacial spasm. The most common offending vessel was the posterior inferior cerebellar artery (39 patients), next was the vertebral artery (23 patients), and last was the anterior inferior cerebellar artery (16 patients). Nineteen of the patients had multiple offending vascular loops. In one patient, another cause of hemifacial spasm was an epidermoid tumor of the cerebellopontine angle. For three patients, it was not possible to determine the exact cause of the facial disorder. Follow-up information was reviewed for 54 of 60 patients; the mean follow-up period was 14 months. Fifty of the patients were in the vessel-nerve conflict group. Forty of the 50 were free of symptoms, and four had marked improvement. The overall success rate was 88%, and there was minimal morbidity (no facial palsy, two cases of severe hearing loss).


1973 ◽  
Vol 118 (3) ◽  
pp. 617-621 ◽  
Author(s):  
BARRY GERALD ◽  
SAMUEL M. WOLPERT ◽  
HERMAN HAIMOVICI

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