Birua Gyani J S, Tyagi Gaurav, Beniwal Manish, Srinivas Dwarakanath, Rao Shilpa
Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Department of Neuropathology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
J Neurosci Rural Pract. 2021 Sep 7;12(4):800-803. doi: 10.1055/s-0041-1735243. eCollection 2021 Oct.
Parenchymal perianeurysmal cysts are rare. We report a case of 50-year-old woman who presented with persistent headaches and episodes of vomiting for the last 2 months. Magnetic resonance imaging of the brain showed a well-defined solitary cystic lesion with a mural nodule measuring 5.4 × 5.2 × 4.6 cm in the right basifrontal region. The mural nodule was cortically based. It was hypointense on T2-weighted fluid-attenuated inversion recovery and showed intense contrast enhancement with few nonenhancing areas-no evidence of diffusion restriction. The cyst wall was nonenhancing, and magnetic resonance angiogram was unremarkable. Differential diagnoses included intra-axial gliomas such as ganglioglioma and pleomorphic xanthoastrocytoma. Right pterional craniotomy and a transcortical approach were made. Subtotal excision of cyst and clipping of right middle cerebral artery bifurcation thrombosed aneurysm were done. After 6 months of follow-up, patient is stable without any deficits. A parenchymal perianeurysmal cyst is a rare entity; it is crucial to be considered a differential diagnosis in any cystic lesion with the mural nodule.
实质内动脉瘤旁囊肿很罕见。我们报告一例50岁女性，在过去2个月中出现持续性头痛和呕吐发作。脑部磁共振成像显示在右基底额叶区域有一个边界清晰的孤立性囊性病变，伴有一个壁结节，大小为5.4×5.2×4.6厘米。壁结节位于皮质。在T2加权液体衰减反转恢复序列上呈低信号，增强扫描显示强化明显，仅有少数无强化区域，无扩散受限证据。囊肿壁无强化，磁共振血管造影未见异常。鉴别诊断包括轴内胶质瘤，如节细胞胶质瘤和多形性黄色星形细胞瘤。进行了右侧翼点开颅和经皮质入路。囊肿次全切除并夹闭右侧大脑中动脉分叉处血栓形成的动脉瘤。随访6个月后，患者情况稳定，无任何神经功能缺损。实质内动脉瘤旁囊肿是一种罕见的病变；对于任何伴有壁结节的囊性病变，将其作为鉴别诊断至关重要。
