Akamatsu Yousuke, Sugawara Takayuki, Mikawa Shigeki, Saito Atsushi, Ono Sadafumi, Takayama Kazuo, Jokura Hidefumi, Seki Hirofumi
Departments of Neurosurgery, Iwate Prefecture Central Hospital, Morioka City, Iwate, Japan.
J Neurosurg. 2009 Mar;110(3):543-6. doi: 10.3171/2008.8.JNS08177.
A 75-year-old woman underwent Gamma Knife surgery (GKS) for a vestibular schwannoma. Eight years after GKS, she suffered sudden onset of headache. Computed tomography revealed diffuse subarachnoid hemorrhage around the cisterns of the posterior fossa. Right vertebral artery angiography showed an aneurysm arising from the lateral pontomedullary segment of the left anterior inferior cerebellar artery. The aneurysm was not located at a branching site. Trapping of the distal anterior inferior cerebellar artery aneurysm was performed, and the aneurysm was removed. The pathological features of this aneurysm are discussed. This aneurysm was diagnosed as a pseudoaneurysm pathologically. This is the first report of aneurysm formation with pathological findings following GKS for a vestibular schwannoma.
一名75岁女性因前庭神经鞘瘤接受了伽玛刀手术（GKS）。GKS术后8年，她突然出现头痛。计算机断层扫描显示后颅窝池周围弥漫性蛛网膜下腔出血。右椎动脉血管造影显示动脉瘤起源于左小脑前下动脉脑桥延髓外侧段。动脉瘤不在分支部位。对小脑前下动脉远端动脉瘤进行了套扎，并切除了动脉瘤。讨论了该动脉瘤的病理特征。该动脉瘤经病理诊断为假性动脉瘤。这是首例关于前庭神经鞘瘤GKS术后动脉瘤形成及病理结果的报告。
