title: Ruptured distal anterior inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: case report.
abstract: A 73-year-old woman presented with diffuse subarachnoid hemorrhage from a ruptured fusiform aneurysm directly arising from the right distal anterior inferior cerebellar artery. Six years before admission, she had undergone stereotactic irradiation for right vestibular schwannoma, under a diagnosis based on neuroimaging. The aneurysm was located within the radiation field. We performed trapping and resection of the aneurysm via a right lateral suboccipital craniotomy, and the patient made a good recovery. Histological examination revealed no evidence of elastic lamina in the aneurysm wall, suggesting pseudoaneurysm caused by radiation-induced vascular injury. Aneurysm formation after radiotherapy is relatively rare and often manifests as fatal hemorrhage. Long-term surviving patients who have received intracranial irradiation should undergo sequential follow up for possible vascular involvement.
authors.affiliation: Department of Neurosurgery, Hakodate Central Hospital, Hakodate, Hokkaido, Japan. yama-shu@med.hokudai.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kato
authors.forename: Makoto
authors.initials: M
authors.lastname: Takeda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikeda
authors.forename: Kei
authors.initials: K
authors.lastname: Kitamura
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000209:etiology* / Q000601:surgery; D003399:Craniotomy; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology* / Q000601:surgery; D009464:Neuroma, Acoustic / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology*; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D012422:Rupture, Spontaneous; D013238:Stereotaxic Techniques; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed