title: Successful treatment of a ruptured flow-related aneurysm in a patient with hemangioblastoma: Case report and review of literature.
abstract: BACKGROUND
  No cerebral aneurysms on the feeder associated with hemangioblastomas that ruptured before resection have been reported. We report a patient with a ruptured flow-related aneurysm associated with cerebellar hemangioblastoma and a tumor feeder treated simultaneously by a single procedure of embolization using N-butyl cyanoacrylate before tumor removal.
  
  
  METHODS
  A 36-year-old female with a cerebellar tumor was admitted to our institute. Four days later, she suffered a massive subarachnoid hemorrhage mainly in the posterior fossa. Left vertebral angiograms showed an aneurysm on the feeding artery, posterior inferior cerebellar artery. Both the aneurysm and its main feeder were simultaneously treated by a single procedure of embolization using N-butyl cyanoacrylate. Their complete obliteration was confirmed angiographically. Four days after the procedure, we removed the tumor and the embolized aneurysm. The pathological diagnosis was hemangioblastoma and flow-related ruptured aneurysm.
  
  
  CONCLUSIONS
  Cerebral angiography should be performed to rule out vascular abnormalities such as cerebral aneurysms adjacent to the tumor in patients with hemangioblastoma who present with intracranial hemorrhage. We emphasize the usefulness of embolization with N-butyl cyanoacrylate for hemangioblastoma with ruptured feeder aneurysm, by which the aneurysm and the feeder could be simultaneously embolized.
authors.affiliation: Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Umeoka
authors.affiliation: Department of Neurosurgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, Japan.
authors.forename: Shushi
authors.initials: S
authors.lastname: Kominami
authors.affiliation: Department of Neurosurgery, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyoku, Tokyo, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Morita
keywords: Cerebral aneurysm; N-butyl cyanoacrylate; embolization; hemangioblastoma; subarachnoid hemorrhage