Benson P J, Sung J H
Department of Pathology, Hennepin County Medical Center, Minneapolis, Minnesota.
J Neurosurg. 1989 Apr;70(4):545-50. doi: 10.3171/jns.1989.70.4.0545.
Three patients, two males and one female aged 21, 14, and 31 years, respectively, developed cerebral saccular aneurysms several years after undergoing radiotherapy for cerebellar medulloblastoma at 2, 5, and 14 years of age, respectively. Following surgery, all three received combined cobalt-60 irradiation and intrathecal colloidal radioactive gold (198Au) therapy, and died from rupture of the aneurysm 19, 9, and 17 years after the radiotherapy, respectively. Autopsy examination revealed no recurrence of the medulloblastoma, but widespread radiation-induced vasculopathy was found at the base of the brain and in the spinal cord, and saccular aneurysms arose from the posterior cerebral arteries at the basal cistern or choroidal fissure. The aneurysms differed from the ordinary saccular aneurysms of congenital type in their location and histological features. Their locations corresponded to the areas where intrathecally administered colloidal 198Au is likely to pool, and they originated directly from a segment of the artery rather than from a branching site as in congenital saccular aneurysms. It is, therefore, concluded that the aneurysms in these three patients were most likely radiation-induced.
三名患者，两名男性和一名女性，年龄分别为21岁、14岁和31岁，他们分别在2岁、5岁和14岁时接受小脑髓母细胞瘤放疗数年后发生了脑囊状动脉瘤。手术后，三人都接受了钴-60照射和鞘内注射胶体放射性金（198Au）治疗，并分别在放疗后19年、9年和17年死于动脉瘤破裂。尸检显示髓母细胞瘤无复发，但在脑底部和脊髓发现广泛的放射性血管病变，囊状动脉瘤起源于基底池或脉络膜裂的大脑后动脉。这些动脉瘤在位置和组织学特征上与先天性普通囊状动脉瘤不同。它们的位置与鞘内注射胶体198Au可能聚集的区域相对应，并且它们直接起源于动脉段，而不是像先天性囊状动脉瘤那样起源于分支部位。因此，得出结论，这三名患者的动脉瘤很可能是辐射诱发的。
