Perianeurysmal parenchymal cyst of the pons: A case report and review of literature

Pedro, Karlo M.; Sih, Ibet Marie

doi:10.1016/j.inat.2020.100731

Cited by 6 publications

(12 citation statements)

References 15 publications

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“…Several theories have been put forward on the etiology of perianeurysmal cyst formation 2 3 5. These include the water hammer effect of the aneurysm on surrounding brain causing gliosis, especially when an aneurysm has been embolized with coils as the sac will become more rigid, perhaps explaining why some cysts occur post-treatment 2 3. Another theory cites ischemia as the cause of gliosis and cyst formation.…”

Section: Discussionmentioning

confidence: 99%

“…Intracranial perianeurysmal cysts are a rare finding in patients with cerebral aneurysms and have been increasingly reported since Marcoux et al first published their findings in 2002 1–12. Perianeurysmal cysts are a different entity from subarachnoid cysts which on occasion can be found surrounding an aneurysm 13–15.…”

Section: Introductionmentioning

confidence: 99%

“…Perianeurysmal cysts may increase in size after diagnosis and may cause secondary mass effect and hydrocephalus, necessitating intervention 1 4 6 9–12. Pedro et al have also reported a case where a perianeurysmal cyst confounded the diagnosis, leading to initial impressions of these lesions being hemangiomas or gliomas until intraoperative inspection revealed an underlying aneurysm 2. Thus, it is important to be aware of cases where a cystic lesion may actually have an underlying aneurysm.…”

Section: Introductionmentioning

confidence: 99%

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Intracranial perianeurysmal cysts: case series and review of the literature

Liang

Efendy²,

Winter

et al. 2021

J NeuroIntervent Surg

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BackgroundIntracranial perianeurysmal cysts are a rare finding associated with cerebral aneurysms. Patients may present with symptoms secondary to mass effect from perianeurysmal cysts requiring drainage. These lesions can masquerade as neoplasms if dedicated vascular imaging is not performed, leading to misdiagnosis.MethodA retrospective search of our database was done for intracranial aneurysms that have been treated between 1998 and 2020. A literature search was then performed on PubMed and Google Scholar with the search terms ‘aneurysm’, ‘intracranial/intracerebral’, ‘cyst’, and ‘perianeurysmal cyst’. Patient demographics, aneurysms and cysts characteristics were then summarized as a table and in the discussion.ResultsThree cases where intracranial aneurysm had associated perianeurysmal cysts were found in our database. Combined with the available literature a total of 19 cases of perianeurysmal cysts have thus far been reported since this entity was first described in 2002. A significant number of perianeurysmal cysts (5/19) required intervention. In 5/19 cases the patient presented with a perianeurysmal cyst without a history of subarachnoid hemorrhage. Of the 10 cases where aneurysm follow-up was reported there were 5 cases where there was aneurysm recurrence necessitating re-treatment.ConclusionSignificant variability exists in the patient demographics, aneurysm and cyst characteristics of perianeurysmal cysts. This suggests that there is no single unified etiology and pathogenesis. These lesions are a rare finding and at present do not appear to carry diagnostic or prognostic significance. Management of perianeurysmal cysts is case-dependent and intervention should be considered when treating the related aneurysm, especially in patients with secondary symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracranial perianeurysmal cysts: case series and review of the literature

Liang

Efendy²,

Winter

et al. 2021

J NeuroIntervent Surg

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“…Sato et al defined a perianeurysmal cyst (2000) 7 as a structure with signal intensity and attenuation characteristics compatible with fluid that lay within the parenchyma adjacent to the aneurysm that did not communicate with the ventricles or cisternal spaces. The development of cyst surrounding an aneurysm is rare, and only 16 cases have been reported in English language literature, 1 6 7 8 9 10 11 12 13 14 15 with the largest case series of five by Sato et al (2000). 7 The case of the perianeurysmal cyst was described by Hirota et al (1999) in a man with a previous history of subarachnoid hemorrhage (SAH).…”

Section: Discussionmentioning

confidence: 99%

“…Cyst formation is seen in various intracranial pathologies ranging from congenital or acquired to infectious or tumor related. 1 Occasionally, cyst formation is also seen in cavernous angiomas 2 3 and arteriovenous malformation. 4 5 However, the development of cyst in the cerebral aneurysm is rare.…”

Section: Introductionmentioning

confidence: 99%

Large Parenchymal Perianeurysmal Cyst: A Case Report

Birua

Tyagi

Beniwal

et al. 2021

J Neurosci Rural Pract

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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.

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