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Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature

Objectives Radiation-induced aneurysm is a rare complication for head and neck tumors. Only seven cases of an aneurysm after stereotactic radiosurgery and/or stereotactic radiotherapy (SRT) have been described. We report two patients with a ruptured internal carotid artery (ICA) aneurysm presenting...

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Autores principales: Fujita, Koji, Tamura, Manabu, Masuo, Osamu, Sasaki, Takahiro, Yamoto, Toshikazu, Fukai, Junya, Nakao, Naoyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242894/
https://www.ncbi.nlm.nih.gov/pubmed/25485213
http://dx.doi.org/10.1055/s-0034-1383859
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author Fujita, Koji
Tamura, Manabu
Masuo, Osamu
Sasaki, Takahiro
Yamoto, Toshikazu
Fukai, Junya
Nakao, Naoyuki
author_facet Fujita, Koji
Tamura, Manabu
Masuo, Osamu
Sasaki, Takahiro
Yamoto, Toshikazu
Fukai, Junya
Nakao, Naoyuki
author_sort Fujita, Koji
collection PubMed
description Objectives Radiation-induced aneurysm is a rare complication for head and neck tumors. Only seven cases of an aneurysm after stereotactic radiosurgery and/or stereotactic radiotherapy (SRT) have been described. We report two patients with a ruptured internal carotid artery (ICA) aneurysm presenting with catastrophic epistaxis after repeated SRT for an anterior skull base tumor. Results Two male patients received repeated SRT in various combinations following surgery for an anterior skull base tumor. They presented with significant epistaxis due to rupture of the aneurysm of the ICA 6 and 77 months after the final SRT, respectively. The aneurysms were located within the radiation field. Preoperative angiography had revealed no aneurysms. Thus the aneurysms in these cases were most likely induced by the repeated SRT. Conclusions This is a proven report of aneurysm formation following repeated SRT without conventional radiotherapy. SRT may be very effective to control malignant skull base tumors. However, the possible development of radiation-induced aneurysm of the ICA should be considered in the case of repeated SRT. The surviving patients who have received SRT should undergo sequential follow-up for possible vascular involvement.
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spelling pubmed-42428942014-12-05 Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature Fujita, Koji Tamura, Manabu Masuo, Osamu Sasaki, Takahiro Yamoto, Toshikazu Fukai, Junya Nakao, Naoyuki J Neurol Surg Rep Article Objectives Radiation-induced aneurysm is a rare complication for head and neck tumors. Only seven cases of an aneurysm after stereotactic radiosurgery and/or stereotactic radiotherapy (SRT) have been described. We report two patients with a ruptured internal carotid artery (ICA) aneurysm presenting with catastrophic epistaxis after repeated SRT for an anterior skull base tumor. Results Two male patients received repeated SRT in various combinations following surgery for an anterior skull base tumor. They presented with significant epistaxis due to rupture of the aneurysm of the ICA 6 and 77 months after the final SRT, respectively. The aneurysms were located within the radiation field. Preoperative angiography had revealed no aneurysms. Thus the aneurysms in these cases were most likely induced by the repeated SRT. Conclusions This is a proven report of aneurysm formation following repeated SRT without conventional radiotherapy. SRT may be very effective to control malignant skull base tumors. However, the possible development of radiation-induced aneurysm of the ICA should be considered in the case of repeated SRT. The surviving patients who have received SRT should undergo sequential follow-up for possible vascular involvement. Georg Thieme Verlag KG 2014-08-05 2014-12 /pmc/articles/PMC4242894/ /pubmed/25485213 http://dx.doi.org/10.1055/s-0034-1383859 Text en © Thieme Medical Publishers
spellingShingle Article
Fujita, Koji
Tamura, Manabu
Masuo, Osamu
Sasaki, Takahiro
Yamoto, Toshikazu
Fukai, Junya
Nakao, Naoyuki
Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature
title Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature
title_full Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature
title_fullStr Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature
title_full_unstemmed Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature
title_short Ruptured Internal Carotid Artery Aneurysm Presenting with Catastrophic Epistaxis after Repeated Stereotactic Radiotherapies for Anterior Skull Base Tumor: Case Reports and Review of the Literature
title_sort ruptured internal carotid artery aneurysm presenting with catastrophic epistaxis after repeated stereotactic radiotherapies for anterior skull base tumor: case reports and review of the literature
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242894/
https://www.ncbi.nlm.nih.gov/pubmed/25485213
http://dx.doi.org/10.1055/s-0034-1383859
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