Ruptured distal anterior inferior cerebellar artery aneurysm following stereotactic irradiation for vestibular schwannoma: case report.
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.
Yamaguchi
Shigeru
S
Department of Neurosurgery, Hakodate Central Hospital, Hakodate, Hokkaido, Japan. yama-shu@med.hokudai.ac.jp
Kato
Tsutomu
T
Takeda
Makoto
M
Ikeda
Hitoshi
H
Kitamura
Kei
K
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