Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China.
Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing, China; Department of Neurosurgery, Stroke Center, Sapporo Teishinkai Hospital, Hokkaiido, Japan.
World Neurosurg. 2019 Jul;127:284-288. doi: 10.1016/j.wneu.2019.04.023. Epub 2019 Apr 12.
Anterior inferior cerebellar artery (AICA) aneurysm is a rare cerebral entity, and its presentation in association with a hypervascularized tumor is even more exceptional. In this study, we describe a patient with rare coexistent pathologic conditions in combination with a cerebellar hypervascularized tumor with an outflow-related AICA aneurysm. A 1-stage procedure to remove both lesions was carried out after meticulous discussion with patient. Postoperative imaging demonstrated no residual aneurysm and total resection of the tumor, which was pathologically diagnosed as hemangioblastoma (HB). She made an excellent neurologic outcome and was discharged in unremarkable condition. At her 3-month follow-up visit, her condition remained stable for vasculopathologic states and neurologic functions. To our knowledge, this is the first published clinical experience regarding cerebellar HB coexistent with an AICA aneurysm that involved the efferent segment of the tumor's feeding vessel. Patients with coexistent vascular pathologic conditions should be aggressively treated, not by the wait-and-see practice, in case of unexpected rupture in the future.
小脑前下动脉（AICA）动脉瘤是一种罕见的脑部病变，而其与富血管性肿瘤同时存在则更为罕见。在本研究中，我们描述了一位同时存在罕见合并病变的患者，其合并小脑富血管性肿瘤和与流出道相关的 AICA 动脉瘤。经过与患者的仔细讨论，我们进行了 1 期手术来切除这两个病变。术后影像学检查显示无残留动脉瘤和肿瘤全切除，病理诊断为血管母细胞瘤（HB）。她的神经功能恢复良好，并在无明显异常的情况下出院。在她 3 个月的随访中，她的血管病理状态和神经功能保持稳定。据我们所知，这是首例报道小脑 HB 合并 AICA 动脉瘤的临床经验，涉及肿瘤供血血管的传出段。对于同时存在血管病理状况的患者，应积极治疗，而不是采取观望的做法，以防将来发生意外破裂。
