Association between an aneurysm of the anterior inferior cerebral artery and an arteriovenous malformation fed by the same artery

Abstract

An unusual case of distal aneurysm of the anterior inferior cerebellar artery (AICA) associated with a cerebellar arteriovenous malformation in a 35 year-old woman is reported. The clinical presentation was a subarachnoid hemorrhage, that is the sudden onset of headache while she was driving her car. In the following days the patient experienced a cerebellopontine angle syndrome: unsteadiness, tinnitus and hearing loss in her left ear, along with drop episodes. All symptoms disappeared in about a week. She consulted a neurosurgeon only a month later. On the day of admission in the Neurosurgical Department of Résidence du Parc Clinic her neurological status was normal. Neuroradiological investigations showed the association between the two distal AICA malformations. At surgery it was possible either to clip the aneurysm or to remove the AVM. The origin of the hemorrhage has not been clearly identified. The patient had an uneventful recovery and returned to her job three months later. The aneurysm was located on the same artery that supplied the AVM. This association is rare at the AICA level. The possible development of the aneurysm induced by increase in flow through the AVM is discussed in the light of Literature data.