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Distal Outflow-related Anterior Inferior Cerebellar Artery Aneurysm in Hemangioblastoma.

08:00 EDT 12th April 2019 | BioPortfolio

Summary of "Distal Outflow-related Anterior Inferior Cerebellar Artery Aneurysm in Hemangioblastoma."

Anterior inferior cerebellar artery (AICA) aneurysm is a rare cerebral entity and its presentation in association with a hyper-vascularized tumor is even more exceptional. In this study, we presented a patient with rare coexistent pathologies in combination of a cerebellar hypervascularized tumor with an outflow related AICA aneurysm. A one-stage procedure to remove both lesions was carried out following meticulous discussion with patient. Postoperative imaging demonstrated no residual of aneurysm and total resection of tumor which was pathologically diagnosed as hemangioblastoma (HB). She made an excellent neurological outcome and discharged unremarkably. Her 3-month follow-up remains stable for vasculopathologies and neurological functions. To our knowledge, this is the first clinical experience regarding the cerebellar HB coexistent with a AICA aneurysm that involved the efferent segment of tumor's feeding vessel. Patients with coexistent vascular pathologies should be aggressively treated other than wait-and-see in case of unexpected rupture in the future. A 38-year-old female complained of a 2-month history of headache. Approximately fifteen days prior to our service, she experienced sudden onset of vomiting with severe headache. The patient was referred to a regional hospital and her emergent computed tomography (CT) results ruled out hemorrhagic event. In the next couple days, magnetic resonance (MR) imaging was prescribed with the detection of a cerebellar mass and she was transferred to SanBo Brain Hospital, Capital Medical University for further management. On examination, her neurological function and laboratory evaluation were unremarkable. Preoperative cranial contrast-enhanced MR imaging showed an enhancing, solid nodule (28×20×28mm) in the cistern of cerebellar pontine angle (CPA) with intraluminal flow-void signal (Fig. 1). Catheter angiography of vertebral artery demonstrated a diffused, large-scale tumor stain in the left cerebellum fed by the left flocculopeduncular segment of AICA (a3) - consistent with hemangioblastoma (HB) (Fig. 2). Meanwhile, a fusiform aneurysm of superior branch of a3 was noted.

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Name: World neurosurgery
ISSN: 1878-8769
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Medical and Biotech [MESH] Definitions

Ischemia or infarction of the spinal cord in the distribution of the anterior spinal artery, which supplies the ventral two-thirds of the spinal cord. This condition is usually associated with ATHEROSCLEROSIS of the aorta and may result from dissection of an AORTIC ANEURYSM or rarely dissection of the anterior spinal artery. Clinical features include weakness and loss of pain and temperature sensation below the level of injury, with relative sparing of position and vibratory sensation. (From Adams et al., Principles of Neurology, 6th ed, pp1249-50)

NECROSIS occurring in the ANTERIOR CEREBRAL ARTERY system, including branches such as Heubner's artery. These arteries supply blood to the medial and superior parts of the CEREBRAL HEMISPHERE, Infarction in the anterior cerebral artery usually results in sensory and motor impairment in the lower body.

Artery formed by the bifurcation of the internal carotid artery (CAROTID ARTERY, INTERNAL). Branches of the anterior cerebral artery supply the CAUDATE NUCLEUS; INTERNAL CAPSULE; PUTAMEN; SEPTAL NUCLEI; GYRUS CINGULI; and surfaces of the FRONTAL LOBE and PARIETAL LOBE.

The anterior and posterior arteries created at the bifurcation of the popliteal artery. The anterior tibial artery begins at the lower border of the popliteus muscle and lies along the tibia at the distal part of the leg to surface superficially anterior to the ankle joint. Its branches are distributed throughout the leg, ankle, and foot. The posterior tibial artery begins at the lower border of the popliteus muscle, lies behind the tibia in the lower part of its course, and is found situated between the medial malleolus and the medial process of the calcaneal tuberosity. Its branches are distributed throughout the leg and foot.

A polygonal anastomosis at the base of the brain formed by the internal carotid (CAROTID ARTERY, INTERNAL), proximal parts of the anterior, middle, and posterior cerebral arteries (ANTERIOR CEREBRAL ARTERY; MIDDLE CEREBRAL ARTERY; POSTERIOR CEREBRAL ARTERY), the anterior communicating artery and the posterior communicating arteries.

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