Matsumoto Hiroaki, Minami Hiroaki, Yamaura Ikuya, Yoshida Yasuhisa
Department of Neurosurgery, Eisyokai Yoshida Hospital; Kobe, Japan -
Department of Neurosurgery, Eisyokai Yoshida Hospital; Kobe, Japan.
Interv Neuroradiol. 2014 Jul-Aug;20(4):448-53. doi: 10.15274/INR-2014-10039. Epub 2014 Aug 28.
Radiation-induced cerebral aneurysms are rare. We describe a case of radiation-induced cerebral aneurysm successfully treated with endovascular coil embolization. A 39-year-old man received 60 Gy of radiation to a pineal germinoma at eight years old. The left internal carotid artery (ICA) aneurysm which developed within the irradiated field and stenotic change in the left ICA due to radiation-induced vasculopathy were detected incidentally. Because these aneurysms show a high risk of rupture and mortality, and even small aneurysms are prone to rupture, any such suspected aneurysm should be treated with surgical or endovascular procedures. Endovascular treatment is probably useful if the aneurysm is inaccessible to direct surgery. Special attention must be paid to treatment because of stenotic changes in cerebral vessels within the irradiated field.
放射性脑动脉瘤较为罕见。我们描述了一例通过血管内弹簧圈栓塞成功治疗的放射性脑动脉瘤病例。一名39岁男性在8岁时因松果体生殖细胞瘤接受了60 Gy的放疗。偶然发现了在放疗区域内形成的左颈内动脉(ICA)动脉瘤以及因放射性血管病变导致的左ICA狭窄改变。由于这些动脉瘤破裂风险和死亡率高,即使是小动脉瘤也容易破裂,任何此类疑似动脉瘤都应采用手术或血管内治疗手段。如果动脉瘤无法直接手术,血管内治疗可能会有用。由于放疗区域内脑血管存在狭窄改变,治疗时必须格外小心。