Peyre Matthieu, Ozanne Augustin, Bhangoo Ranjeev, Pereira Vitor, Tadié Marc, Lasjaunias Pierre, Parker Fabrice
Department of Neurosurgery, Bicêtre Hospital, Le Kremlin Bicêtre, France.
Neurosurgery. 2007 Sep;61(3):E658; discussion E658. doi: 10.1227/01.NEU.0000290919.47847.D7.
Neurofibromatosis Type 1 (NF1) is known to be associated with vascular lesions. Association with an extracranial vertebral artery aneurysm is very rare. We report the case of such an aneurysm mimicking a cervical neurofibroma in NF1.
An 18-year-old woman with previously diagnosed NF1 presented with a C6 radiculopathy. There were no clinical features suggesting a vascular origin for the lesion. The computed tomographic and standard magnetic resonance imaging scans showed a C5-C6 contrast-enhancing lesion responsible for bony erosion. Subsequent, magnetic resonance angiography and digital subtraction angiography diagnosed the lesion as a C5-C6 vertebral artery aneurysm.
The lesion was treated by endovascular occlusion of both the aneurysm and the parent vertebral artery with an initial immediate disappearance of the pain.
This case serves as a reminder of the importance of ruling out a vertebral artery aneurysm with angiography when managing cervical lesions in patients with NF1.
已知1型神经纤维瘤病(NF1)与血管病变有关。与颅外椎动脉动脉瘤相关的情况非常罕见。我们报告了1例在NF1中表现为颈部神经纤维瘤的此类动脉瘤病例。
一名先前诊断为NF1的18岁女性出现C6神经根病。没有临床特征提示该病变起源于血管。计算机断层扫描和标准磁共振成像扫描显示一个C5 - C6对比增强病变,导致骨质侵蚀。随后,磁共振血管造影和数字减影血管造影将该病变诊断为C5 - C6椎动脉动脉瘤。
通过血管内闭塞动脉瘤及其供血椎动脉对病变进行治疗,疼痛最初立即消失。
该病例提醒我们,在处理NF1患者的颈部病变时,通过血管造影排除椎动脉动脉瘤的重要性。