Minim Invasive Neurosurg 2004; 47(5): 306-311
DOI: 10.1055/s-2004-830091
Original Article
© Georg Thieme Verlag Stuttgart · New York

Relationship between Anterior Inferior Cerebellar Artery and Facial-Vestibulocochlear Nerve Complex: An Anatomical and Magnetic Resonance Images Correlation Study

T.  Yurtseven1 , R.  Savaş2 , A.  Koçak3 , T.  Turhan1 , E.  O.  Aktaş3 , S.  Işlekel1
  • 1Department of Neurosurgery, Ege University, Faculty of Medicine, Bornova, Izmir, Turkey
  • 2Department of Radiology, Ege University, Faculty of Medicine, Bornova, Izmir, Turkey
  • 3Department of Forensic Medicine, Ege University, Faculty of Medicine, Bornova, Izmir, Turkey
Further Information

Publication History

Publication Date:
02 December 2004 (online)

Abstract

For the successful microneurosurgical treatment of CP angle located pathologies, an understanding of the relationship and variations between neural and vascular structures and a certain diagnosis are the most valuable factors for surgeons. CP angle lesions have now become a visible area by advances in magnetic resonance imaging (MRI) technology. An evaluation of this area and the decision for a neurosurgical decompression procedure are easier than before. Twenty unfixed adult human cadaver specimens, that have no sign of central nervous system pathology, were obtained and dissected bilaterally at routine autopsy. The facial-vestibulocochlear (VII - VIIIth) nerve complex and the anterior inferior cerebellar artery (AICA) were identified in all specimens. Thirteen of the 40 (32.5 %) AICA were situated ventrally and fourteen (35 %) were located dorsally to the VII - VIIIth nerve complex. Thirteen (32.5 %) passed between the VIIth and the VIIIth nerve fibers. Five of the 40 (12.5 %) AICA had a loop near the nerve complex and then passed the nerves ventrally or dorsally. In an MRI study 74 adult persons (148 sides) were investigated by using three-dimensional Fourier transformation constructive interference in the steady state technique (3D FT-CISS) on a 1.5 Tesla MRI system (Siemens Magnetom, Erlangen, Germany). The results were as follows; 48 AICA (32.4 % of all 148 AICA) were situated ventrally to the VII - VIIIth nerve complex, 45 AICA (30.4 %) were situated dorsally to the VII-VIIIth nerve complex, and the AICA passed between the VIIth and VIIIth nerves in 51 samples (34.5 %). In four of the 148 CP angles (2.7 %), the AICA was not identified. There was an AICA loop coursing to the internal acoustic meatus in 15 patients (10.1 %). In this study, we examined the relations between VIIth and VIIIth nerve complex and the AICA in cadaver and MRI materials for an understanding of the value and reliability of the radiological data. This study also shows the anatomical variation between these structures.

References

  • 1 Sakaki T, Morimoto T, Miyamoto S, Kyoi K, Utsumi S, Hyo Y. Microsurgical treatment of patients with vestibular and cochlear symptoms.  Surg Neurol. 1987;  27 141-146
  • 2 Van H T, Deguine O, Esteve-Fraysse M J, Bonafe A, Fraysse B. Relationship between cochleovestibular disorders in hemifacial spasm and neurovascular compression.  Laryngoscope. 1999;  109 741-747
  • 3 Hansen C, Montgomery Jr E B. Hemifacial spasm: medical treatment. In: Carter LP, Spetzler RF (eds.). Neurovascular Surgery. New York: McGraw-Hill 1995: 1119-1131
  • 4 Mustafa M K, Weerden T W van, Mooij J J. Hemifacial spasms caused by neurovascular compression.  Neurosurgery. 2001;  49 1365-1370
  • 5 0kamura T, Kurokawa Y, Ikeda N, Abiko S, Ideguchi M, Watanabe K, Kido T. Microvascular decompression for cochlear symptoms.  J Neurosurg. 2000;  93 421-426
  • 6 Rhoton Jr A L. Microsurgical anatomy of the brainstem surface facing an acoustic neuroma.  Surg Neurol. 1986;  25 326-339
  • 7 Marinkovic S, Kovacevic M, Gibo H, Milisavljevic M, Bumbasirevic L. The anatomical basis for the cerebellar infarcts.  Surg NeuroI. 1995;  44 450-461
  • 8 Janetta P l. Observation on the etiology of trigeminal neuralgia, hemifacial spasm, acoustic nerve dysfunction and glossopharyngeal neuralgia. Definitive microsurgical treatment and results in 117 patients.  Neurochirurgia. 1977;  20 145-154
  • 9 Schultze F. Linksseitiger Fascialiskrampf in Folge eines Aneurysma der Arteria vertebralis sinistra.  Virchows Arch. 1875;  65 385-391
  • 10 Lang J. Skull Base and Related Structures, Atlas of Clinical Anatomy. Stuttgart: Schattauer 1995: 248
  • 11 Perneczky A. The anterior inferior cerebellar artery. Anatomy, clinical aspects and microneurosurgery.  Fortschr Med. 1981;  99 511-514
  • 12 Mazzoni A. Internal auditory canal: Arterial relations at the porus acusticus.  Ann Otol Rhinol Laryngol. 1969;  78 797-814
  • 13 Han J. Microanatomical relationships of the anterior inferior cerebellar artery and the facial nerve.  Zhonghua Er Bi Yan Rou Ke Za Zhi. 1990;  25 133-134, 189
  • 14 Nagahiro S, Takada A, Matsukado Y, Ushio Y. Microvascular decompression for hemifacial spasm.  J Neurosurg. 1991;  75 388-392
  • 15 Atkinson W J. The anterior inferior cerebellar artery: Its variations, pontine distribution, and significance in the surgery of cerebellopontine angle tumours.  J Neurol Neurosurg Psychiatry. 1949;  12 137-151
  • 16 McDermott A L, Dutt S N, Irving R M, Pahor A L, Chavda S V. Anterior inferior cerebellar artery syndrome: fact or fiction.  Clin OtolarygoI. 2003;  28 75-80
  • 17 Martin R G, Grant J L, Peace D A, Theiss C, Rhoton Jr A L. Microsurgical relationships of the anterior inferior cerebellar artery and the facial-vestibulocochlear nerve complex.  Neurosurgery. 1980;  6 483-507
  • 18 Sunderland S. The arterial relations of the internal auditory meatus.  Brain. 1945;  68 23-27
  • 19 Casselman J W, Kuhweide R, Deimling M, Ampe W, Dehaene I, Meeus L. Constructive interference in steady state 3D-FT MR imaging of the inner ear and cerebellopontine angle.  Am J Neuroradiology. 1993;  14 47-57
  • 20 Chung S S, Chang J W, Kim S R, Chang J R, Park Y G, Kim D I. Microvascular decompression of the facial nerve for the treatment of hemifacial spasm: Preoperative magnetic resonance imaging related to clinical outcomes.  Acta Neurochir (Wien). 2000;  142 901-907
  • 21 Girard N, Poncet M, Caces F, Tallon Y, Chays A, Martin-Bouyer P, Mangan J, Raybaud C. Three-dimensional MRI of hemifacial spasm with surgical correlation.  Neuroradiology. 1997;  39 46-51
  • 22 Bernardi B, Zimmerman R A, Savino P J, Adler C. Magnetic resonance tomographic angiography in the investigation of hemifacial spasm.  Neuroradiology. 1993;  35 606-611
  • 23 Kumon Y, Sakaki S, Kohno K, Ohta S, Ohue S, Miki H. Three-dimensional imaging for presentation of the causative vessels in patients with hemifacial spasm and trigeminal neuralgia.  Surg NeuroI. 1997;  47 178-184
  • 24 Du C, Korogi Y, Nagahiro S, Sakamoto Y, Takada A, Ushio Y, Hirai T, Higashida Y, Takahashi M. Hemifacial spasm; Three-dimensional MR images in the evaluation of neurovascular compression.  Radiology. 1995;  197 227-231
  • 25 Nagaseki Y, Horikoshi T, Omata T, Ueno T, Uchida M, Nukui H, Tsuji R, Sasaki H. Oblique sagittal magnetic resonance imaging visualizing vascular compression of the trigeminal or facial nerve.  J Neurosurg. 1992;  77 379-386
  • 26 Boecher-Schwarz H G, Bruehl K, Kessel G, Guenther M, Perneczky A, Stoeter P. Sensitivity and specificity of MRA in the diagnosis of neurovascular compression in patients with trigeminal neuralgia. A correlation of MRA and surgical findings.  Neuroradiology. 1998;  40 88-95

Taşkin YurtsevenM. D. 

Department of Neurosurgery · Ege University · School of Medicine Bornova

Izmir 35100

Turkey

Phone: +90-232-388-3042

Fax: +90-232-373-1330 ·

Email: taskiny@med.ege.edu.tr

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