title: Coincidence of an anterior cerebral artery aneurysm and a glioblastoma: case report and review of literature.
abstract: BACKGROUND
  The association between glioblastoma and intracranial aneurysm is rare. Treatment guidelines do not exist, and operative mortality and morbidity are significantly high. To our knowledge, no prior cases have employed endovascular therapy for the treatment of these intra-tumor intracranial aneurysms followed by tumor resection.
  
  
  METHODS
  A 74-year-old male, history of a left A2 aneurysm, presented after a motor vehicle accident at low speeds. Imaging was concerning for a possible traumatic brain contusion, an aneurysmal hemorrhage given history of left A2 aneurysm, or a hemorrhage from an underlying tumor given profound edema. The patient was discussed at the brain tumor board, where the plan was to address the aneurysm followed by resection of the mass versus close monitoring with subsequent imaging. The high risk of rehemorrhage, given the real possibility of an aneurysmal hemorrhage, motivated prompt treatment of the aneurysm. The patient was taken to the angiography suite; an anterosuperiorly projecting azygous A2 aneurysm, measuring 4.5 mm × 5.5 mm with a neck width at 3.5 mm and a small daughter sac, was completely obliterated with primary coiling. The following day, he underwent a left craniotomy along a forehead skin crease for mass excision. Final pathology revealed glioblastoma. The patient recovered well from both procedures, with a baseline neurological exam. The patient subsequently underwent hypofractionated radiation and temodar.
  
  
  CONCLUSIONS
  To our knowledge, no prior cases have employed endovascular therapy for the treatment of these intracranial aneurysms. We emphasize that efforts to introduce less invasive elements may improve the overall outcomes in this rare patient population.
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Ha Son
authors.initials: HS
authors.lastname: Nguyen
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Ninh
authors.initials: N
authors.lastname: Doan
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Gelsomino
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Saman
authors.initials: S
authors.lastname: Shabani
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Wade
authors.initials: W
authors.lastname: Mueller
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
keywords: glioblastoma; intracranial aneurysm; traumatic brain injury