Ruptured distal AICA pseudoaneurysm presenting years after vestibular schwannoma resection and radiation

BMJ Case Rep. 2015 May 6:2015:bcr2015011736. doi: 10.1136/bcr-2015-011736.

Abstract

Distal anterior inferior cerebellar artery (AICA) pseudoaneurysms are very rare lesions. Although cases have been previously reported, only a few have been reported as a result of vestibular schwannoma (VS) radiation, none have been reported as a result of VS resection, and only one has been reported as treated with parent vessel occlusion (PVO) with n-butyl cyanoacrylate (nBCA). We report a case of a 65-year-old man with a history of right-sided VS surgery and radiation who presented years later with a ruptured pseudoaneurysm of the distal right AICA and was treated with endovascular PVO using nBCA. The aneurysm was completely obliterated and the patient had no worsening of symptoms or neurological exam. The case illustrates a very rare complication of VS surgery and radiation as well as an effective treatment for distal AICA aneurysms.

Keywords: Aneurysm; Hemorrhage; Liquid Embolic Material; Subarachnoid; Tumor.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aneurysm, False / diagnosis*
  • Aneurysm, False / etiology
  • Aneurysm, Ruptured / diagnosis*
  • Aneurysm, Ruptured / etiology
  • Angiography, Digital Subtraction
  • Cerebellum / blood supply*
  • Chemoembolization, Therapeutic / methods*
  • Ear Neoplasms / radiotherapy
  • Ear Neoplasms / surgery
  • Ear Neoplasms / therapy*
  • Enbucrilate / therapeutic use
  • Endovascular Procedures / methods*
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / etiology
  • Male
  • Neurilemmoma / radiotherapy
  • Neurilemmoma / surgery
  • Neurilemmoma / therapy*
  • Treatment Outcome
  • Vestibule, Labyrinth* / radiation effects
  • Vestibule, Labyrinth* / surgery

Substances

  • Enbucrilate