Republished: Ruptured distal AICA pseudoaneurysm presenting years after vestibular schwannoma resection and radiation

McNeill, Ian T; Mocco, J; Berenstein, Alejandro; DeMattia, Joseph A.; Fifi, Johanna T

doi:10.1136/neurintsurg-2015-011736.rep

Cited by 13 publications

(3 citation statements)

References 33 publications

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“…However, to date, the exact mechanism of a higher incidence of IA in patients with acoustic neuroma remains unclear. Subarachnoid hemorrhage due to rupture of ipsilateral pseudoaneurysm was found in patients with acoustic schwannoma who underwent stereotactic irradiation (21,22), indicating that radiation-induced vascular injury probably facilitated the formation of aneurysms (23). However, patients with acoustic neuroma included in the present study had an absence of any radiative history of brain tumors.…”

Section: Discussionmentioning

confidence: 67%

Higher Prevalence and Age Susceptibility of Intracranial Aneurysm in Patients With Acoustic Neuroma

You

Bai

et al. 2020

Front. Neurol.

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Introduction: The purpose of this study was to verify whether the prevalence of intracranial aneurysm (IA) in patients with acoustic neuroma is greater than that in age-and sex-matched controls and to evaluate the independent risk factors related to the occurrence of IA. Methods: We retrospectively analyzed 231 patients diagnosed with acoustic neuroma at our institute between 2015 and 2019 and 489 controls from the medical examination center. Cerebrovascular angiography was acquired from all subjects to assess the presence of IA or not. The prevalence of IA and risk factors associated with a higher IA occurrence were compared, respectively. Results: Cerebral aneurysms were detected in 23 patients (10.0%) and 11 controls (2.2%). The prevalence of IA was significantly different between patients with acoustic neuroma and controls (p < 0.001), and the difference was mainly reflected in the age of 50 and above. In the subgroup analysis, there were distinct differences in several clinical features including age, hypertension, and tumor volume, and cystic change between patients coexisted with IA or not. However, age was a unique independent risk factor for coexistence of IA in patients with acoustic neuroma after multivariate logistic regression (OR 1.050, 95% CI 1.008-1.093, p = 0.019). Conclusions: Our results demonstrate that patients with acoustic neuroma have a higher prevalence of IA than the general population. Older age is correlated with greater occurrence of IA in these patients.

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Section: Discussionmentioning

confidence: 67%

Higher Prevalence and Age Susceptibility of Intracranial Aneurysm in Patients With Acoustic Neuroma

You

Bai

et al. 2020

Front. Neurol.

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“…The aggravation may result from either the internal auditory artery injury or the direct injury to nerves by surgical manipulation. In addition, in all cases with AICA occlusion we reviewed, except for asymptomatic cerebellum infarction in three cases ( 6 , 10 , 11 ), no other serious complications occurred. Two patients experienced hydrocephalus and brainstem vasospasm, probably due to subarachnoid hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Unruptured anterior Inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: Case report and literature review

Ping²,

Chen³

et al. 2023

Front. Surg.

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BackgroundThe clinical features and therapeutic measures of vestibular schwannoma (VS) radiation-related aneurysm (RRA) have not been well described. We reported the first VS RRA case admitted for acute anterior inferior cerebella artery (AICA) ischemic symptoms. Literature was reviewed to present the research fruits about VS RRAs, and some therapeutic advices were given.Materials and methodsA 54-year-old woman who had undergone GKS 10 years previously for a right VS was admitted to our hospital in 2018 because of sudden onset of severe vertigo and vomiting, accompanied with unsteady gait. During tumor resection, a dissecting aneurysm arose from the main trunk of AICA was encountered accidently within the tumor. The aneurysm was successfully treated with direct clip ligation, sparing the parent vessel. Data about this case were combined with those of other 11 radiation-related AICA aneurysm cases retrieved from the current literature. The following parameters were evaluated: Age, Sex, Diagnostic method, Location of aneurysm, Age of radiotherapy (Years)/Latency, Rupture, x-ray dosage, Type of radiotherapy, History of surgical resection of VS, Aneurysm Type, Morphology, Number, Treatment, Operative complications, Sequela, Outcome. VS RRAs mainly occurred in women (75%) with a median age of 62.5 years and were mainly located on AICA. Ruptured aneurysms accounted for 75.0% of the total cases. This paper reported the first VS case admitted with acute AICA ischemic symptoms. Cases with sacciform-like, irregular and fusiform-shaped aneurysms accounted for 50.0%, 25.0% and 25.0% of the total, respectively. After surgical treatment, 75.0% patients recovered, except for 3 patients who developed new ischemic consequence.ConclusionPatients should be informed of the risk of RRAs after receiving radiotherapy for VS. In these patients, RRAs should be suspected when subarachnoid hemorrhage or AICA ischemic symptoms occurred. Active intervention should be conducted considering the high instability and bleeding rate of VS RRAs.

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“… 1 2 Except a few larger case series, 3 only case reports with a single or a few patients have been reported. 1 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 Drake et al 64 reported a larger series of AICA aneurysms. However, they also included aneurysms originating from the basilar trunk near the origin of AICA.…”

Section: Introductionmentioning

confidence: 99%

Treatment and Outcome of Anterior Inferior Cerebellar Artery (AICA) Aneurysms: Helsinki Series of 15 Consecutive Patients

et al. 2023

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Objective Anterior inferior cerebellar artery (AICA) aneurysms are rare posterior circulation lesions that are challenging to treat. This article presents the treatment and clinical outcome of AICA aneurysms in an unselected cohort of patients. Methods A retrospective analysis of patient record files, digital subtraction angiography, and computed tomography angiography images of 15 consecutive patients harboring AICA aneurysms treated between 1968 and 2017. Results Of the 15 AICA aneurysm patients reviewed, 12 (80%) were females. Twenty percent had intracerebral hemorrhage and 40% presented with intraventricular hemorrhage. Eleven out of 15 (73%) patients presented with subarachnoid hemorrhage (SAH); 82% of SAH patients had a good-grade SAH (Hunt and Hess grade 1–3). Eleven patients (73%) were treated surgically, three (20%) were treated conservatively, and one (7%) had coil embolization. In 27% of patients, a subtemporal approach with anterior petrosectomy was performed. A retrosigmoid approach was used in the remaining 73%. In 18% of the patients, a parent vessel occlusion was necessary to occlude the aneurysm. Five out of 11 (47%) of the patients developed postoperative cranial nerve deficits. Twenty-seven percent developed shunt-dependent hydrocephalus. All patients who presented with an unruptured AICA aneurysm had good clinical outcome (modified Rankin scale [mRS] 1–2). In patients with SAH, 82% achieved good clinical outcome and 18% had poor clinical outcome (mRS 3–6) after 1 year. Conclusion Surgical treatment of AICA aneurysms has a high rate of cranial nerve deficits but most of patients have a good long-term clinical outcome.

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Republished: Ruptured distal AICA pseudoaneurysm presenting years after vestibular schwannoma resection and radiation

Cited by 13 publications

References 33 publications

Higher Prevalence and Age Susceptibility of Intracranial Aneurysm in Patients With Acoustic Neuroma

Higher Prevalence and Age Susceptibility of Intracranial Aneurysm in Patients With Acoustic Neuroma

Unruptured anterior Inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: Case report and literature review

Treatment and Outcome of Anterior Inferior Cerebellar Artery (AICA) Aneurysms: Helsinki Series of 15 Consecutive Patients

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