Intracranial Aneurysms in Previously Irradiated Fields: Literature Review and Case Report

Nanney, Allan D.; Tecle, Najib E. El; Ahmadieh, Tarek Y. El; Daou, Marc; Ivan, Esther N. Bit; Marymont, Maryanne Hoffman; Batjer, H. Hunt; Bendok, Bernard R.

doi:10.1016/j.wneu.2013.10.044

Cited by 63 publications

(61 citation statements)

References 27 publications

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“…Radiation therapy (RT) for intracranial disease causes not only vasculopathy, but also cerebral aneurysm formation 7,8,13,16,17 . The pathogenesis of radiation-induced aneurysms is likely to resemble that of radiation-induced vasculopathy, in which initial endothelial injury caused by radiation results in aneurysmal change 22,27 .…”

Section: Discussionmentioning

confidence: 99%

“…Radiation-induced aneurysms display different clinical characteristics to congenital saccular aneurysms. The rupture rate is high, with even small aneurysms prone to rupture, and the mortality rate for ruptured aneurysms is also high 7,17,27 . Radiation-induced aneurysms often arise directly from a segment of a major artery and are associated with stenotic changes due to radiation-induced vasculopathy in the neighboring arteries situated within the radiation field 4,7,16,24,27 .…”

Section: Discussionmentioning

confidence: 99%

“…Radiation-induced aneurysms are divided into the following three types: saccular; fusiform; and pseudoaneurysm 17 . In cases of saccular aneurysm, neck clipping or coil embolization can be performed.…”

Section: Case Reportmentioning

confidence: 99%

“…On the other hand, several problems are associated with such treatment. First, because radiation-induced aneurysms themselves may be more fragile and prone to rupture than congenital ones 7,10,17 , the possibility of rupture during the procedure must be considered. Second, because the ICA and MCA undergo stenotic changes due to radiation-induced vasculopathy, there is a possibility of embolism when instruments such as microcatheters pass through the ICA and MCA.…”

Section: Case Reportmentioning

confidence: 99%

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Radiation-Induced Cerebral Aneurysm Treated with Endovascular Coil Embolization

et al. 2014

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Radiation-induced cerebral aneurysms are rare. We describe a case of radiation-induced cerebral aneurysm successfully treated with endovascular coil embolization. A 39-year-old man received 60 Gy of radiation to a pineal germinoma at eight years old. The left internal carotid artery (ICA) aneurysm which developed within the irradiated field and stenotic change in the left ICA due to radiation-induced vasculopathy were detected incidentally. Because these aneurysms show a high risk of rupture and mortality, and even small aneurysms are prone to rupture, any such suspected aneurysm should be treated with surgical or endovascular procedures. Endovascular treatment is probably useful if the aneurysm is inaccessible to direct surgery. Special attention must be paid to treatment because of stenotic changes in cerebral vessels within the irradiated field.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

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Radiation-Induced Cerebral Aneurysm Treated with Endovascular Coil Embolization

et al. 2014

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“…Given the overall rarity and uncertain association between SRS and aneurysm formation, we do not recommend routine aneurysm surveillance screening in patients undergoing Gamma Knife radiosurgery for VS. Surgeons should be aware of the rare possibility of encountering an aneurysm during surgical exploration in patients with VS who fail SRS. First reported in 1978, aneurysm formation is a rare but reported complication attributed to radiation therapy (1,2). In 2001, an aneurysm associated with stereotactic radiosurgery (SRS) was first reported (2,3).…”

mentioning

confidence: 99%

Incidentally Discovered Unruptured AICA Aneurysm After Radiosurgery for Vestibular Schwannoma

Hughes

Osetinsky

Jacob

et al. 2015

Otology &Amp; Neurotology

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Although aneurysms associated with posterior fossa SRS are rare, there are at least seven reports, including the current case, in the past decade. Because the relationship between radiation and aneurysm formation is unproven and controversial, further study, especially examining long-term effects, is needed. Given the overall rarity and uncertain association between SRS and aneurysm formation, we do not recommend routine aneurysm surveillance screening in patients undergoing Gamma Knife radiosurgery for VS. Surgeons should be aware of the rare possibility of encountering an aneurysm during surgical exploration in patients with VS who fail SRS.

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Review of Cerebral Radiotherapy‐Induced Vasculopathy in Pediatric and Adult Patients

Osouli

Guo

2023

Advanced Biology

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Radiation therapy (RT) causes radiation‐induced vasculopathy, which requires clinicians to identify and manage this side effect in pediatric and adult patients. This article reviews previous findings about the pathophysiology of RT‐induced vascular injury, including endothelial cell injury, oxidative stress, inflammatory cytokines, angiogenic pathways, and remodeling. The vasculopathy is categorized into ischemic vasculopathy, hemorrhagic vasculopathy, carotid artery injury, and other malformations (cavernous malformations and aneurysms) in populations of pediatric and adult patients separately. The prevention and management of this RT‐induced side effect are also discussed. The article summarizes the distribution and risk factors of different types of RT‐induced vasculopathy. This will help clinicians identify high‐risk patients with corresponding vasculopathy subtypes to deduce prevention and treatment strategies accordingly.

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Intracranial Aneurysms in Previously Irradiated Fields: Literature Review and Case Report

Cited by 63 publications

References 27 publications

Radiation-Induced Cerebral Aneurysm Treated with Endovascular Coil Embolization

Radiation-Induced Cerebral Aneurysm Treated with Endovascular Coil Embolization

Incidentally Discovered Unruptured AICA Aneurysm After Radiosurgery for Vestibular Schwannoma

Review of Cerebral Radiotherapy‐Induced Vasculopathy in Pediatric and Adult Patients

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