Ruptured venous aneurysm of cervicomedullary junction

Abstract

Background:Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM) or developmental venous anomaly (DVA). However, isolated venous aneurysm is unusual.Case Description:We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH). Digital substraction angiography (DSA) revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ). Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 × 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein.Conclusion:This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM) of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.

Perimesencephalic subarachnoid hemorrhage with a positive angiographic finding: case report and review of the literature

“…In contrast, Alexander et al, who studied 140 cases of angiography-negative SAHs, suggested ventriculostriate and thalamoperforating vessels as the source of the bleeding [2]. Recently, Aqqawal et al [1] presented a case with a clipped cervicomedullary junction ruptured venous aneurysm. Extra-cranial, however, true venous aneurysm is often encountered [4,11].…”

Primary axillary venous aneurysm in a young patient presenting with cardiac arrest

“…In a case series of 31 patients, Calligaro et al 14 noted that 71% of patients with deep venous aneurysm of the lower extremity experienced deep venous thrombosis or pulmonary embolism. Rupture of weakened venous aneurysmal tissue secondary to thrombotic obstruction represents another concerning sequela with the potential for fatal hemorrhage, although this complication has rarely been documented 12, 14, 15, 16, 17. A 2010 case report of a 40-year-old woman with a thrombosed external jugular vein aneurysm associated a primary venous aneurysm of the upper body with suspected pulmonary embolism 18 .…”