髓质血管母细胞瘤破裂,模拟脑颈交界处硬脑膜动静脉瘘伴假性动脉瘤。

IF 1.2 Q4 CLINICAL NEUROLOGY
Neurointervention Pub Date : 2023-11-01 Epub Date: 2023-10-23 DOI:10.5469/neuroint.2023.00451
Sangil Park, Boseong Kwon, Deok Hee Lee, Jae-Sung Ahn, Yunsun Song
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引用次数: 0

摘要

血管母细胞瘤是一种罕见的血管肿瘤,常见于成人后颅窝。一名50多岁的患者突然意识不清。计算机断层扫描显示后颅窝周围急性出血,主要发生在蛛网膜下腔。数字减影血管造影术(DSA)显示一个充满造影剂的8mm圆形病变,由左椎动脉(VA)的C1节段动脉供血,显示早期静脉引流至脊髓和脑干。在怀疑硬脑膜动静脉瘘破裂的情况下尝试紧急栓塞,由于喂食器选择失败导致母动脉闭塞。一个月后的DSA随访显示,通过两个VA的侧支血管出现持续性动脉瘤。因此,决定进行手术干预,切除病变,通过组织学检查确认其诊断为HBM。该病例强调了当肿瘤内分流的HBMs模拟血管分流病变时可能会出现误诊。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm.

Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm.

Hemangioblastomas (HBMs) are rare vascular tumors commonly located in the posterior fossa of adults. A mid-50s patient presented with sudden unconsciousness. Computed tomography scans revealed acute hemorrhages around the posterior fossa, predominantly in the subarachnoid space. Digital subtraction angiography (DSA) revealed an 8-mm round lesion filled with contrast agent, fed by the C1 segmental artery of the left vertebral artery (VA), showing early venous drainage to the spinal cord and brainstem. Emergent embolization was attempted under suspicion of a ruptured dural arteriovenous fistula, resulting in parent artery occlusion due to feeder selection failure. Follow-up DSA after a month depicted a persistent aneurysm via collaterals from both VAs. Consequently, the decision was made to proceed with surgical intervention, leading to the resection of the lesion, confirming its diagnosis as a HBM through histological examination. This case underscores the potential for misdiagnosis when HBMs with an intratumoral shunt mimic vascular shunt lesions.

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来源期刊
CiteScore
1.80
自引率
0.00%
发文量
34
审稿时长
12 weeks
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