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.


Journal Details

This article was published in the following journal.

Name: World neurosurgery
ISSN: 1878-8769


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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.

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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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