Successful Clipping of a Giant Anterior Inferior Cerebellar Artery Aneurysm with Combined Transpetrosal Approach

BACKGROUND: The anterior inferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment can be challenging. There are only a few previous reports of surgical treatment for such lesions. OBJECTIVES: We present a case of a basilar-AICA aneurysm undergoing surgery with the combined transpetrosal approach. CASE DESCRIPTION: A 58-year-old female patient presented clinical signs including headache, diplopia, and right hemiparesis. The radiological imaging showed a basilar-AICA aneurysm measuring 25 × 19 mm. The patient was operated via left combined transpetrosal approach. The outcome was graded mRankin 1. Follow-up computerized tomographic angiography showed no aneurysmal residual and total preservation of basilar artery. DISCUSSIONS: Surgical indication's purposes were aneurysmal elimination and reduction of mass effect. Combined transpetrosal approach: proximal segment control and enough space for clipping manipulation. Clipping techniques: Temporary clip for aneurysmal collapsing, “orienting clip”. CONCLUSION: Giant basilar-AICA aneurysm is very rare lesion. Combined transpetrosal approach is appropriate for surgical clipping. Good surgical outcome is achieved with complete elimination of aneurysm.