Case description - Intrameatal thrombosed AICA aneurysm – microsurgical resection and end-to-end anastomosis
The 22-year-old male presented with acute, retroauricular pain on the right side and progressive hearing loss. Despite rheologic infusion treatment, the hearing continued to worsen until the patient finally went deaf. This was accompanied by the development of facial paresis. Imaging diagnostics identified an intrameatal mass on the right. A vestibular schwannoma was suspected. However, the contrast enhancement was not typical of a vestibular schwannoma, nor was the pronounced facial paresis with a small intrameatal lesion. Based on the progressive neurological deficits, the indication for surgery became evident.
Pre-operative Images
Video
Result
Postoperative MR imaging shows the removal of the intrameatal mass. The digital subtraction angiography reveals the patent anastomosis and a well-filled distal AICA (arrows). The facial paresis has completely disappeared. The deafness has remained.