Vates G E, Arthur K A, Ojemann S G, Williams F, Lawton M T
Department of Neurological Surgery, University at San Francisco, University of California, 94143, USA.
Neurosurgery. 2001 Sep;49(3):721-5. doi: 10.1097/00006123-200109000-00036.
Hemorrhage associated with central neurocytoma has been described previously, but never in association with an aneurysm originating from a feeding artery. We present the first reported case of a central neurocytoma in a patient with intraventricular hemorrhage caused by rupture of an aneurysm on a lenticulostriate artery that supplied the tumor.
A 35-year-old man who presented with an intraventricular hemorrhage underwent magnetic resonance imaging and cerebral angiography that disclosed a right lateral intraventricular mass and a 7-mm fusiform aneurysm from a lateral lenticulostriate branch of the right middle cerebral artery.
The patient underwent a contralateral transcallosal exploration and resection of the tumor, with excision of the adjacent lenticulostriate artery aneurysm. Pathological review demonstrated that the tumor was a neurocytoma. The aneurysm was discrete from the tumor but occurred on a vessel that supplied the tumor.
Previous reports have demonstrated that intraventricular neurocytoma may present with tumor hemorrhage. In this case, an aneurysm separate and distinct from the tumor was the bleeding culprit, and the aneurysm was on an artery that fed into the tumor. Any such aneurysm must be identified and treated appropriately for therapy to be complete.
中枢神经细胞瘤相关出血此前已有报道,但从未与源自供血动脉的动脉瘤相关。我们报告首例因供应肿瘤的豆纹动脉上的动脉瘤破裂导致脑室内出血患者的中枢神经细胞瘤病例。
一名出现脑室内出血的35岁男性接受了磁共振成像和脑血管造影,结果显示右侧脑室内有一肿块以及右侧大脑中动脉外侧豆纹分支上有一个7毫米的梭形动脉瘤。
患者接受了经胼胝体对侧入路肿瘤切除术,并切除了相邻的豆纹动脉动脉瘤。病理检查显示肿瘤为神经细胞瘤。动脉瘤与肿瘤不相连,但发生在供应肿瘤的血管上。
既往报道表明脑室内神经细胞瘤可能出现肿瘤出血。在此病例中,与肿瘤分离且不同的动脉瘤是出血原因,且动脉瘤位于供血给肿瘤的动脉上。任何此类动脉瘤都必须被识别并进行适当治疗,以使治疗完整。