Cargando…
Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature
BACKGROUND AND IMPORTANCE: The tendency of posterior fossa arteriovenous malformations (pfAVM) to develop associated aneurysms (AA) is a well-known phenomenon with an increased total risk of rupture. Most pfAVM and AA develop in the territory of the posterior inferior cerebellar artery while the inv...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539170/ https://www.ncbi.nlm.nih.gov/pubmed/28824538 http://dx.doi.org/10.3389/fneur.2017.00382 |
_version_ | 1783254433290780672 |
---|---|
author | Khayat, Hassan A. Alshareef, Fawaz Alshamy, Abdulrahman Algain, Abdulrahman Alhejaili, Essam Alnabihi, Omar Alzahrani, Saeed Stendel, Ruediger |
author_facet | Khayat, Hassan A. Alshareef, Fawaz Alshamy, Abdulrahman Algain, Abdulrahman Alhejaili, Essam Alnabihi, Omar Alzahrani, Saeed Stendel, Ruediger |
author_sort | Khayat, Hassan A. |
collection | PubMed |
description | BACKGROUND AND IMPORTANCE: The tendency of posterior fossa arteriovenous malformations (pfAVM) to develop associated aneurysms (AA) is a well-known phenomenon with an increased total risk of rupture. Most pfAVM and AA develop in the territory of the posterior inferior cerebellar artery while the involvement of the anterior inferior cerebellar artery (AICA) is extremely rare. We describe an unusual case of an arteriovenous malformation (AVM) supplied by the AICA with a “proximal” AA. This unique combination of vascular lesions has been reported in only four cases so far, limiting the available experience that can safely guide the therapeutic intervention. CLINICAL PRESENTATION: This study describes a 59-year-old female presented with a subarachnoid hemorrhage, Hunt and Hess grade 4. Angiography demonstrated an AVM fed mainly by the right AICA and draining superficially into the transverse sinus (Spetzler–Martin grade II). In addition, there was a ruptured proximal AICA aneurysm. An endovascular approach was chosen to coil the aneurysm and obliterate the AVM using ONYX in a multi-staged process. The patient recovered well without residual deficit at 6-month follow-up. CONCLUSION: To the best of our knowledge, this is the first report describing a proximal AICA aneurysm and AVM treated by endovascular means. The outcome was very good, considering the technically demanding location. All previously reported cases with exactly similar lesions were managed surgically, with inconclusive outcomes. The data presented in this study are meant to help in decision-making process for similar cases till more data are available. |
format | Online Article Text |
id | pubmed-5539170 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55391702017-08-18 Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature Khayat, Hassan A. Alshareef, Fawaz Alshamy, Abdulrahman Algain, Abdulrahman Alhejaili, Essam Alnabihi, Omar Alzahrani, Saeed Stendel, Ruediger Front Neurol Neuroscience BACKGROUND AND IMPORTANCE: The tendency of posterior fossa arteriovenous malformations (pfAVM) to develop associated aneurysms (AA) is a well-known phenomenon with an increased total risk of rupture. Most pfAVM and AA develop in the territory of the posterior inferior cerebellar artery while the involvement of the anterior inferior cerebellar artery (AICA) is extremely rare. We describe an unusual case of an arteriovenous malformation (AVM) supplied by the AICA with a “proximal” AA. This unique combination of vascular lesions has been reported in only four cases so far, limiting the available experience that can safely guide the therapeutic intervention. CLINICAL PRESENTATION: This study describes a 59-year-old female presented with a subarachnoid hemorrhage, Hunt and Hess grade 4. Angiography demonstrated an AVM fed mainly by the right AICA and draining superficially into the transverse sinus (Spetzler–Martin grade II). In addition, there was a ruptured proximal AICA aneurysm. An endovascular approach was chosen to coil the aneurysm and obliterate the AVM using ONYX in a multi-staged process. The patient recovered well without residual deficit at 6-month follow-up. CONCLUSION: To the best of our knowledge, this is the first report describing a proximal AICA aneurysm and AVM treated by endovascular means. The outcome was very good, considering the technically demanding location. All previously reported cases with exactly similar lesions were managed surgically, with inconclusive outcomes. The data presented in this study are meant to help in decision-making process for similar cases till more data are available. Frontiers Media S.A. 2017-08-02 /pmc/articles/PMC5539170/ /pubmed/28824538 http://dx.doi.org/10.3389/fneur.2017.00382 Text en Copyright © 2017 Khayat, Alshareef, Alshamy, Algain, Alhejaili, Alnabihi, Alzahrani and Stendel. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Khayat, Hassan A. Alshareef, Fawaz Alshamy, Abdulrahman Algain, Abdulrahman Alhejaili, Essam Alnabihi, Omar Alzahrani, Saeed Stendel, Ruediger Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature |
title | Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature |
title_full | Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature |
title_fullStr | Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature |
title_full_unstemmed | Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature |
title_short | Pure Endovascular Management of an Arteriovenous Malformation and an Aneurysm Both Supplied by Anterio-Inferior Cerebellar Artery: A Case Report and a Review of Literature |
title_sort | pure endovascular management of an arteriovenous malformation and an aneurysm both supplied by anterio-inferior cerebellar artery: a case report and a review of literature |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539170/ https://www.ncbi.nlm.nih.gov/pubmed/28824538 http://dx.doi.org/10.3389/fneur.2017.00382 |
work_keys_str_mv | AT khayathassana pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT alshareeffawaz pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT alshamyabdulrahman pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT algainabdulrahman pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT alhejailiessam pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT alnabihiomar pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT alzahranisaeed pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature AT stendelruediger pureendovascularmanagementofanarteriovenousmalformationandananeurysmbothsuppliedbyanterioinferiorcerebellararteryacasereportandareviewofliterature |