The former Rangers midfielder has been sidelined with another worrying eye condition, while his team-mate is facing four weeks out with an ankle problem
Of the two withdrawals, the case of Gattuso is the more worrying, with the midfielder having been diagnosed with ocular myasthenia, a disease of the neuromuscular junction which has been brought on a by a form of influenza that he contracted during the Rossoneri's recent trip to Dubai.
According to the club's official website, Gattuso, who has previously suffered diplopia in his left eye, must now undergo a period of rest while he receives treatment for the condition. It is not yet known how long he will be out of action for.
Aquilani, meanwhile, will be sidelined for a month with an ankle injury.
Milan go into the derby joint top of Serie A with Juventus, eight points clear of fifth-placed Inter, who have won five games on the bounce.