A fully thrombosed giant posterior inferior cerebellar aneurysm mimicking an intracranial tumour in a child

Lan, Zhi Gang; Ma, Lu; Duan, Jie; You, Chao

doi:10.3109/02688697.2012.690911

Cited by 16 publications

(9 citation statements)

References 3 publications

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“…Burkhardt et al demonstrated ruptured PICA aneurysm was an independent risk factor of abducens nerve palsy 59 . Giant aneurysms might be misdiagnosed as tumors of posterior fossa due to similar symptoms and imaging features which were sometimes indistinguishable even with magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) 46 , 47 . Computed tomography angiography (CTA) is insensitive to the distal PICA aneurysms resulting from the thin lumen of PICA.…”

Section: Aneurysmmentioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. The PICA has tortuous and variable course and territory, divided into 5 segments. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. PICA injured by head trauma can cause fatal SAH. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.

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Section: Aneurysmmentioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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show abstract

“…It is the result of hematogenous spread from a primary focus in the lung [ 12 ]. In clinical field, it is not so rare to misdiagnosed thrombosed aneurysm as a brain tumor, however, thrombosed aneurysms mimicking intracranial neoplasm have been reported only in 4 cases previously ( Table 1 ) [ 13 , 14 , 15 , 16 ]. It might be because it seems not so valuable to report.…”

Section: Discussionmentioning

confidence: 99%

“…But, in this case, it seemed valuable to share, because as mentioned above, it was not so big as giant aneurysms and the location of aneurysm was lenticulostriate artery which is rare. Among the other reported cases, the aneurysms of 2 cases [ 13 , 16 ] were included in a category of giant aneurysm and the aneurysms of 3 cases [ 13 , 14 , 16 ] were located in posterior circulation. Every patient of the reported cases was managed successfully by controlling the parent arteries and totally removing the thrombosed aneurysm, and the outcomes were excellent.…”

Section: Discussionmentioning

confidence: 99%

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Thrombosed Large Middle Cerebral Artery Aneurysm Mimicking an Intra-Axial Brain Tumor: Case Report and Review of Literature

Kim

Jeun

Park

2015

Brain Tumor Res Treat

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This case report presents a fully thrombosed large aneurysm of middle cerebral artery mimicking an intra-axial brain tumor in a 54-year-old male patient. A small mass like lesion was found incidentally in right frontal area. Brain magnetic resonance image showed dark signal intensity on T2-weighted images and peripheral high signal intensity on T1-weighted images with peripheral rim enhancement. We considered intra-axial tumors such as glioma or metastatic tumor as a differential diagnosis. The lesion was approached transcortically, and intraoperatively, the lesion was found to be a large thrombosed aneurysm originating from the lateral lenticulostriate artery of right middle cerebral artery. One vascular clip was applied at the parent artery, and the thrombosed aneurysm was totally removed. There have been many reports of other intracranial lesions wrongly diagnosed as intracranial neoplasms. And thrombosed aneurysms mimicking intracranial neoplasm have been reported in 4 cases previously. According to those case reports, there were no efficient imaging tools to differentiate between these thrombosed aneurysms and intracranial neoplasms. We reviewed those reports and considered about the efficient method to diagnosed accurately before surgery. To sum up, when a patient presents with an intracranial lesion lying on the course of major or distal cerebral arteries, the surgeon should have thrombosed aneurysm in mind as one of the differential diagnosis and be prepared when surgically treating such lesions.

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“…There have been rare reports where completely thrombosed aneurysms have imitated neoplasms based on initial presentation and imaging. [ 9 11 12 17 24 ] Though up to 40% of cerebral aneurysms involve the middle cerebral artery,[ 4 16 ] no cases have been reported along the middle cerebral artery. Here, we describe a patient with seizure activity where serial contrast-enhanced MRI brain studies demonstrated a persistent rim-enhancing lesion with surrounding fluid-attenuated inversion recovery (FLAIR) signal concerning for a neoplastic process.…”

Section: Introductionmentioning

confidence: 99%

A completely thrombosed, nongiant middle cerebral artery aneurysm mimicking an intra-axial neoplasm

et al. 2015

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Background:Few reports exist regarding thrombosed aneurysms where the initial work up was concerning for a neoplasm. To date, no published reports exist regarding a nongiant thrombosed middle cerebral artery aneurysm, where the primary workup and treatment plan was directed toward a preliminary diagnosis of intra-axial neoplasm.Case Description:We report a 43-year-old female who presented with a generalized tonic-clonic seizure attributed to a lesion along the right superior temporal gyrus. The lesion enhanced on initial magnetic resonance imaging (MRI) of the brain, as well as on follow-up MRI. Subsequent vascular studies and metastatic work up were negative. A craniotomy with image guidance was performed and an intraoperative diagnosis was made of a thrombosed aneurysm along a branch of the middle cerebral artery. The aneurysm was trapped and resected as there was no significant flow from the branch as seen on the prior cerebral angiogram. The patient had an uneventful postoperative course.Conclusion:Completely thrombosed, nongiant aneurysms can mimic an intra-axial neoplasm. Typical imaging features for thrombosed aneurysms may be missed, especially if the aneurysms are small, where imaging characteristics of the intraluminal contents is more difficult to appreciate. Although imaging may be consistent with a neoplastic lesion, there should be suspicion for a potential underlying aneurysm.

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A fully thrombosed giant posterior inferior cerebellar aneurysm mimicking an intracranial tumour in a child

Cited by 16 publications

References 3 publications

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Thrombosed Large Middle Cerebral Artery Aneurysm Mimicking an Intra-Axial Brain Tumor: Case Report and Review of Literature

A completely thrombosed, nongiant middle cerebral artery aneurysm mimicking an intra-axial neoplasm

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