title: Ruptured venous aneurysm of cervicomedullary junction.
abstract: BACKGROUND
  Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM) or developmental venous anomaly (DVA). However, isolated venous aneurysm is unusual.
  
  
  METHODS
  We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH). Digital substraction angiography (DSA) revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ). Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 × 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein.
  
  
  CONCLUSIONS
  This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM) of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Aggarwal
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: Pravin
authors.initials: P
authors.lastname: Salunke
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Futane
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: S N
authors.initials: SN
authors.lastname: Mathuriya
authors.affiliation: Department of Radiodiagnosis, PGIMER, Chandigarh, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Mukherjee
authors.affiliation: Department of Pathology, PGIMER, Chandigarh, India.
authors.forename: B D
authors.initials: BD
authors.lastname: Radotra
keywords: Arterio-venous malformation; cervico medullary junction; venous aneurysm