An intracranial aneurysm on the feeding artery of a cerebellar hemangioblastoma

Guzman, Raphael; Grady, M. Sean

doi:10.3171/jns.1999.91.1.0136

Cited by 33 publications

(21 citation statements)

References 17 publications

(12 reference statements)

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“…Feeding artery aneurysms with coexisting tumors have been reported in other intracranial tumors, such as meningiomas, hemangioblastomas, and neurocytomas. 9,29,30) In our case, the aneurysm was found in a recurrent glioma with malignant transformation. We supposed that tumor cell invasion into the feeding artery was involved in the aneurysm formation, but we could not find any tumor cells in the resected aneurysm wall.…”

Section: Discussionmentioning

confidence: 92%

De Novo Aneurysm in the Feeding Artery of a Recurrent Malignant Glioma -Case Report-

Sasagawa

Akai

Itou

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 52-year-old man underwent resection of an oligodendroglioma in the left frontal lobe, followed by chemoradiation therapy in 1989. He presented with a de novo aneurysm arising from the feeding artery of a recurrent malignant glioma in 2009. Serial follow-up magnetic resonance imaging showed no tumor progression until 19 years after the initial diagnosis. Angiography revealed an intratumoral aneurysm of the dilated feeding artery. The recurrent tumor was resected together with the aneurysm. Histological examination revealed that the tumor was an anaplastic oligodendroglioma, and the aneurysm was encased in the tumor. Clinicians should carefully look for tumor recurrence and aneurysm formation during follow up of patients treated for malignant glioma.

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Section: Discussionmentioning

confidence: 92%

De Novo Aneurysm in the Feeding Artery of a Recurrent Malignant Glioma -Case Report-

Sasagawa

Akai

Itou

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…They tend to occur predominantly in the meatal segment or dorsolateral branch of the AICA 2) , and their occurrence in association with a high-flow lesion, such as an AVM or cerebellar hemagioblastoma, has scarcely been reported 1,[6][7][8][9][10][11]14,16) . The association of a distal AICA aneurysm with an AVM fed by the same artery has been described in only 11 cases elsewhere 1,[6][7][8]10,11,14,16) .…”

Section: Discussionmentioning

confidence: 99%

A Case of Ruptured Peripheral Aneurysm of the Anterior Inferior Cerebellar Artery Associated with an Arteriovenous Malformation : A Less Invasive Image-Guided Transcortical Approach

Lee

Koh

Bang

et al. 2009

J Korean Neurosurg Soc

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A 47-year-old man presented with a subarachnoid hemorrhage (SAH) and right cerebellar hematoma was referred for evaluation. Cerebral angiography revealed a distal anterior inferior cerebellar artery (AICA) aneurysm associated with an arteriovenous malformation (AVM). Successful obliteration and complete removal of the aneurysm and AVM were obtained using transcortical approach under the guidance of neuronavigation system. The association of a peripheral AICA aneurysm and a cerebellar AVM by the same artery is unique. The reported cases of conventional surgery for this disease complex are not common and their results are variable. Less invasive surgery using image-guided neuronavigation system would be helpful and feasible for a peripheral aneurysm combining an AVM of the posterior fossa in selective cases

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“…Skeletonizing the transverse sigmoid junction, including the anterior aspect of the sigmoid sinus, allows the sinus to be retracted laterally to obtain extra space, minimizing retraction over the cerebellum. It offers a straight corridor between the cranial nerves (Vth and VIIth) to access the origin of the AICA from the basilar artery 3 .The retrosigmoid approach offers an excellent route to distal aneurysms on the postmeatal or meatal segments of the artery 3,9 . It is not suitable to approach giant proximal AICA aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…By 1989, only 33 cases had been reported in the literature [1][2][3][4] . Subsequently, numerous case reports and small series of AICA aneurysms have been reported 1,2,[5][6][7][8][9][10][11][12][13][14][15] . Giant aneurysms of proximal portion of AICA are even more uncommon, being difficult to estimate their actual incidence.…”

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confidence: 99%

A giant partially thrombosed aica aneurysm

Figueiredo

Gomes

Neto

et al. 2008

Arq. Neuro-Psiquiatr.

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Aneurysms of the anteroinferior cerebellar artery (AICA) are rare, comprising far less than 1% of all intracranial aneurysms. By 1989, only 33 cases had been reported in the literature [1][2][3][4] . Subsequently, numerous case reports and small series of AICA aneurysms have been reported 1,2,[5][6][7][8][9][10][11][12][13][14][15] . Giant aneurysms of proximal portion of AICA are even more uncommon, being difficult to estimate their actual incidence. These aneurysms constitute formidable surgical challenge and a judicious preoperative planning is mandatory since surgical nuances often determined the final outcome.We present a case of giant partially thrombosed AICA aneurysm and discuss operative nuances required to minimize the morbidity associated with such surgically challenging lesions. CASEA 62 years old female presented sudden headache. At emergency room, neurological examination revealed meningismus. TC scan disclosed subarachnoid hemorrhage. Angiographic evaluation diagnosed three aneurysms at left middle cerebral artery, posterior communicating artery and a small left AICA aneurysm (Fig 1). Anterior circulation aneurysms were treated trough a left pterional approach. Postoperative course was uneventful. After two years, she returned complaining of trigeminal disestesias. Neurological examination displayed mild left facial paresis and right hemiparesis. TC scan revealed image suggestive of a thrombosed aneurysm compressing brainstem. This finding was confirmed by angiotomography and digital angiography that demonstrated giant thrombosed AICA aneurysm (Fig 2). Occlusion balloon test was carried out and patient stood asymptomatic after thirty minutes of occlusion.A right transcocclear approach was performed and the facial nerve was skeletomized and mobilized. Vertebral arteries, basilar trunk and AICA were identified and dissected (Fig 3). Temporary clips were applied proximal and distally, aneurysm sac was incised. Thrombus was removed in order to deflate the aneurysm. Two fenestrated clips were applied to the neck to preserve AI-CA (Fig 4). Two temporary clipping (thirty minutes each) were necessary to performing these maneuvers. Abdominal fat pad was harvested and used to pack the petrosal space and a catheter for lumbar drainage was inserted.Definitive deficits were deafness in the right side and right facial paresis. Postoperative angiogram disclosed adequate surgical result (Fig 5). The patient has agreed with this case publication. DISCUSSIONThe surgical exposure of AICA aneurysms is difficult due to distance of the lesions from the cranial base and their close relationship to the brainstem and lower cranial

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An intracranial aneurysm on the feeding artery of a cerebellar hemangioblastoma

Cited by 33 publications

References 17 publications

De Novo Aneurysm in the Feeding Artery of a Recurrent Malignant Glioma -Case Report-

De Novo Aneurysm in the Feeding Artery of a Recurrent Malignant Glioma -Case Report-

A Case of Ruptured Peripheral Aneurysm of the Anterior Inferior Cerebellar Artery Associated with an Arteriovenous Malformation : A Less Invasive Image-Guided Transcortical Approach

A giant partially thrombosed aica aneurysm

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