Subarachnoid Hemorrhage Because of Distal Superior Cerebellar Artery Dissection in Neurofibromatosis Type 1

Takeshima, Y.; Ohmori, Yuki; Nakagawa, Takashi; Kaku, Yasuyuki; Kuratsu, Jun‐ichi; Yano, Shigetoshi

doi:10.1016/j.wneu.2017.06.052

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…One patient had a vertebro‐vertebral arteriovenous fistula which has been previously reported in association with NF1 (Higa et al, 2010). A few case reports in the literature describe patients with NF1 and arterial dissection (Takeshima et al, 2017; Tateishi et al, 2019; Yoshida & Tobe, 2005). We report two patients with NF1 and superficial siderosis following surgery, and two further cases are reported in the literature (Gonzalez‐Pinto et al, 2018; Matsumoto et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Neurovascular complications in adults with Neurofibromatosis type 1: A national referral center experience

Sheerin

Holmes

Childs

et al. 2022

American J of Med Genetics Pt A

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Neurofibromatosis type 1 (NF1) is associated with a range of vascular abnormalities.To assess the frequency, clinical and imaging spectrum of vascular complications in an adult cohort of NF1 patients, we reviewed 2068 adult NF1 patient records seen in our service between 2009 and 2019, to determine presence of vascular abnormalities, age at detection, associated symptoms and management. A literature review of the range of vascular abnormalities associated with NF1 was also undertaken. 1234 patients had magnetic resonance imaging cranial imaging. The frequency of vascular abnormalities associated with NF1 patients who had cranial imaging in this cohort was 3.5% (n = 43), the majority (n = 26, 60%) were symptomatic. Stroke and cerebral arterial stenosis were the commonest vascular complication. Eight patients (0.65%) had more than one type of vascular abnormality. One death due to a vascular complication was identified and significant morbidity resulted from other complications. We conclude that clinicians caring for patients with NF1 need to be cognizant that rapid onset of new neurological symptoms or signs may be the result of a vascular complication of NF1 and require urgent investigation and management, ideally within specialist teams who have experience of managing vascular complications of NF1.

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Section: Discussionmentioning

confidence: 99%

Neurovascular complications in adults with Neurofibromatosis type 1: A national referral center experience

Sheerin

Holmes

Childs

et al. 2022

American J of Med Genetics Pt A

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“…Neurofibromatoses encountered in the field of neurosurgery are mostly neoplastic diseases, such as acoustic neuroma, meningioma, and optic glioma. While moyamoya vessels [4][5][6], internal carotid artery occlusion, and stenosis [9,11] are common cerebrovascular lesions, dural arteriovenous fistula [5,14] and cerebral artery dissection [8] have also been identified in NF1 patients. To date, not many case reports have investigated complications of intracranial aneurysms [10,12,13,15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Well-known complications in the central nervous system associated with this disease include neurofibroma and optic glioma. In addition, some studies have demonstrated cardiovascular anomalies in NF1, such as moyamoya disease, internal carotid artery occlusion or stenosis, cerebral arteriovenous fistula, dissection, or intracranial aneurysms [4][5][6][7][8][9][10][11][12][13]. Here, we report a case of NF1 with subarachnoid hemorrhage due to multiple and de novo aneurysms.…”

Section: Introductionmentioning

confidence: 90%

Neurofibromatosis type 1 with subarachnoid hemorrhage due to multiple and de novo aneurysms: a case report

et al. 2021

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Background Neurofibromatosis type 1 causes various lesions in many organs including the skin, and the incidence of complications with intracranial aneurysms is 9–11%. Here we report a case of neurofibromatosis type 1 with subarachnoid hemorrhage due to multiple and de novo aneurysms. Case presentation The patient was a 49-year-old Japanese woman with a history of neurofibromatosis type 1. She was transported to our hospital owing to disturbance of consciousness and was diagnosed with subarachnoid hemorrhage by computed tomography. Computed tomography angiography revealed multiple, small intracranial aneurysms, and we suspected that one of them in the peripheral branch of the left middle cerebral artery was the source of hemorrhage based on the distribution of hematoma. The patient underwent emergency surgery. Because it was difficult to identify an aneurysm in the most peripheral part of the left middle cerebral artery in the initial surgery, only one aneurysm was clipped. Later, a peripheral aneurysm was clipped using the navigation system. Because both aneurysms were small intracranial aneurysms (< 2 mm), either of them could be the source of hemorrhage. The postoperative course was good, and the patient was discharged in healthy condition. Because brain magnetic resonance imaging performed in the previous year did not find aneurysms at the same site, she was diagnosed with rupture of a de novo aneurysm. Neurofibromatosis type 1 might have caused the rupture of multiple intracranial aneurysms in a short period in this patient. Conclusion Neurofibromatosis type 1 may be complicated by the formation of multiple intracranial aneurysms in a short period.

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“…Indication for Revascularization of the Distal SCA Treatment options for distal SCA aneurysms include direct clipping, 3,7 trapping, 11 wrap/clip reconstruction, 8 and endovascular coiling/embolization. 5,6,13 When the shape of the aneurysm is amenable for simple clipping or coiling, patency of the parent artery should be preserved.…”

Section: Discussionmentioning

confidence: 99%

“…9 Several cases of dissecting aneurysms of the distal SCA have also been reported in the literature. 8,11 Notably, previous reports have mentioned that the risk of ischemic complications appears to be relatively small because of good collateral flow between the SCA and the anterior inferior and posterior inferior cerebellar arteries through the vermis. 3,5 However, a sufficient collateral flow after SCA occlusion currently cannot be objectively evaluated due to the lack of an appropriate index.…”

Section: Discussionmentioning

confidence: 99%

Superficial temporal artery–superior cerebellar artery bypass and trapping of a fusiform aneurysm using intradural anterior petrosectomy: technical case report and anatomical study

Oya

Indo

Nagashima

et al. 2019

Neurosurgical Focus

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Aneurysms at the distal portion of the superior cerebellar artery (SCA) are very rare. Because of the deep location and a propensity for nonsaccular morphology, aneurysm trapping or endovascular occlusion of the parent artery are the usual treatment options, which are associated with varying risks of ischemic complications. The authors report on a 60-year-old woman who had a 3.5-mm unruptured aneurysm in the lateral pontomesencephalic segment of the SCA with a significant interval growth to 8 mm. Direct surgical intervention comprising trapping of the aneurysm through a subtemporal approach and intradural anterior petrosectomy combined with revascularization of the distal SCA using the superficial temporal artery (STA) was performed. This approach provided sufficient space for the bypass instruments to be introduced into the deep surgical field at a more favorable angle to enhance microscopic visualization of the anastomosis with minimal retraction of the temporal lobe. The patient was discharged with no neurological deficit. Preservation of the blood flow in the distal SCA should be attempted to minimize the risk of ischemic injury, particularly when the aneurysms arise in the anterior or lateral segment of the SCA. The authors demonstrate the safety and effectiveness of the intradural anterior petrosectomy for STA-SCA bypass along with a relevant anatomical study.

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Subarachnoid Hemorrhage Because of Distal Superior Cerebellar Artery Dissection in Neurofibromatosis Type 1

Cited by 5 publications

References 28 publications

Neurovascular complications in adults with Neurofibromatosis type 1: A national referral center experience

Neurovascular complications in adults with Neurofibromatosis type 1: A national referral center experience

Neurofibromatosis type 1 with subarachnoid hemorrhage due to multiple and de novo aneurysms: a case report

Superficial temporal artery–superior cerebellar artery bypass and trapping of a fusiform aneurysm using intradural anterior petrosectomy: technical case report and anatomical study

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