【摘要】 目的 探讨小脑前下动脉(AICA)动脉瘤的临床特征、治疗方式的选择及操作技巧。 方法 回顾性分析5例AICA动脉瘤的临床资料。 结果 AICA 远端囊性动脉瘤3例，其中2例位于内听道口，1例位于小脑绒球腹侧、面听神经背侧，并伴有同侧小脑半球小型隐匿性血管畸形，术中借助神经内窥镜发现动脉瘤，3例均行手术夹闭，并于术后住院期间行脑血管造影复查，夹闭满意;AICA近端囊性动脉瘤2例，均采用血管内介入治疗。患者预后优4例，良1例。 结论 AICA远端动脉瘤宜首选手术夹闭，术中辅助神经内窥镜有助于提高显微手术效果;AICA近端动脉瘤宜首选血管内介入治疗。清华大学玉泉医院神经外科孙基栋

【关键词】 小脑前下动脉;动脉瘤; 显微手术;血管内介入栓塞

Five cases report of anterior inferior cerebellar artery aneurysms WU Hong-xi, SUN Ji-dong, QU Yuan-ming, XU Guang-ming, Li Guo-xin, Wang Xiao-dong Department of Neurosurgery, Shandong Provincial Hospital, Jinan 250021, China

【Abstract】 -ive To explore the clinical characteristics and treatment methods of anterior inferior cerebellar artery(AICA) aneurysms. Methods Clinical data of 5 AICA-aneurysms in 5 patients were analyzed retrospectively. Results Three cases of distal saccular AICA aneurysms, which diamerter was 16mm in one and no larger than 5mm in the other two, were clipped. Two aneurysms were located near the internal auditory meatus, the other one was at the ventral surface of the flocculus cerebelli and the dorsal surface of the VII、VIII cranial nerves, which had a small occult AVM at the homolateral cerebellar hemisphere was found in operation by neuro-endoscope. All 3 were clipped satisfactorily, as confirmed by postoperative angiogram in hospital; Two cases of proximal saccular AICA aneurysms were cured by endovascular embolization. On follow-up, four patients were excellent and one good. Conclusion The distal AICA aneurysms are suitable for surgical clip, and the microsurgical effect could be improved by using neuro-endoscope; However, the proximal AICA aneurysms should be treated by endovascular embolization.

【Key words】Anterior inferior cerebellar artery(AICA); Aneurysm; Endoscope; Microneurosurgery; Endovascular embolization

中图分类号：R651.1+2

小脑前下动脉(AICA)动脉瘤是十分少见的颅内动脉瘤。1948年Schwarz首次报告此病，国内陈振平(1990年)报道2例，占同期205例颅内动脉瘤的0.98%[2]。我院自1995年6月至2005年10月共治疗颅内动脉瘤513例，其中AICA动脉瘤5例(0.97%)。现将这5例报告如下，并结合文献对其分型、临床特点、治疗方式的选择及操作技巧进行讨论。