Relationship between anterior inferior cerebellar artery
and facial-vestibulocochlear nerve complex: an anatomical and magnetic resonance images correlation study.
(24) Unilateral vertebral artery occlusion seldom results in neurologic deficits if the contralateral vertebral artery is not injured, is of adequate size, and the posterior inferior cerebellar artery
(PICA) blood supply on the side of occlusion is preserved (Figure 3).
The three-dimension road map was acquired by conducting a 3-dimensional rotating angiography (3D-RA), which clearly revealed a right cerebellar bAVM of 3.1 cm x 3.2 cm x 2.2 cm in size with the feeders from the branches of the right superior cerebellar artery (SCA), anterior inferior cerebellar artery
(AICA), and posterior inferior cerebellar artery
The acousticofacial bundle (vestibulocochlear nerve: CN VIII and facial nerve: CN VII), fundus of the internal acoustic canal, and anterior inferior cerebellar artery
(AICA) were observed at the central compartment of CPA (Figure 3).
The implicating vessel is usually the posterior inferior cerebellar artery
(PICA), which frequently also compresses on the rootlets of the vagus nerve.
The patient underwent cerebral angiography and a lobule-irregular contouring saccular aneurysm of the size of approximately 4-5 mm was detected in the right vertebral artery at the level of the posterior inferior cerebellar artery
orifice; then the patient underwent endovascular aneurysm embolization.
A magnetic resonance imaging (MRI) examination revealed an infarct on the left posterior inferior cerebellar artery
(PICA) supply area.
Visualization of the vascular structure and the nerve is best achieved in oblique sagittal gradient MR imaging, which is reported to have a 75.9% sensitivity for identification of facial nerve compression by the anterior inferior cerebellar artery
or the posterior inferior cerebellar artery
, the first and second most common offending vessels, respectively.
Computed tomography (CT) of the head and CT angiography of the head and neck revealed an unruptured 11.7-millimeter wide-necked left posterior inferior cerebellar artery
(PICA) aneurysm that was subsequently confirmed with conventional cerebral angiography.
LVA--left vertebral artery, Py--pyramid, RVA--right vertebral artery, BA--basilar artery, RinCA--right inferior cerebellar artery
, and LinCA--left inferior cerebellar artery
The most common offending vessel is the superior cerebellar artery followed by the anterior and inferior cerebellar artery