PDF(Pubmed)
Abstract：
UNASSIGNED: Aneurysmal formation after stereotactic radiosurgery (SRS) for vestibular schwannoma (VS) is a rare complication. Its characteristics and the best treatment strategies remain controversial, and the clinical course is especially unknown because reported aneurysms are first incidentally detected, or aneurysmal rupture occurs suddenly, and they are treated immediately.
UNASSIGNED: A 68-year-old man who underwent SRS for VS 20 years ago presented with subarachnoid hemorrhage (SAH) due to rupture of a radiation-induced fusiform anterior inferior cerebellar artery aneurysm. He was treated with parent artery occlusion, resulting in a modified Rankin scale grade 2. This report illustrates the first case of detected aneurysm formation before rupture with retrospective magnetic resonance imaging evaluation.
UNASSIGNED: We describe the possible risk of rapid progression and rupture of aneurysms, focusing on the interval from SRS to aneurysmal formation. The period of formation of SRS-induced aneurysms is suspected to vary from years to decades regardless of radiation doses; however, aneurysms estimated as pseudoaneurysms have an extremely high risk of rupture within a few years, even when small in size. If aneurysms are discovered unruptured, there are some advantages in not only the prevention of poor prognosis due to SAH but also in the availability of optional therapeutic strategies using revascularization. Long-term annual follow-up, including vessel examination, is warranted not only to assess tumor status but also for early detection of any vascular lesions.
UNASSIGNED: A 68-year-old man who underwent SRS for VS 20 years ago presented with subarachnoid hemorrhage (SAH) due to rupture of a radiation-induced fusiform anterior inferior cerebellar artery aneurysm. He was treated with parent artery occlusion, resulting in a modified Rankin scale grade 2. This report illustrates the first case of detected aneurysm formation before rupture with retrospective magnetic resonance imaging evaluation.
UNASSIGNED: We describe the possible risk of rapid progression and rupture of aneurysms, focusing on the interval from SRS to aneurysmal formation. The period of formation of SRS-induced aneurysms is suspected to vary from years to decades regardless of radiation doses; however, aneurysms estimated as pseudoaneurysms have an extremely high risk of rupture within a few years, even when small in size. If aneurysms are discovered unruptured, there are some advantages in not only the prevention of poor prognosis due to SAH but also in the availability of optional therapeutic strategies using revascularization. Long-term annual follow-up, including vessel examination, is warranted not only to assess tumor status but also for early detection of any vascular lesions.
摘要：
■立体定向放射外科（SRS）治疗前庭神经鞘瘤（VS）后的动脉瘤形成是一种罕见的并发症。其特点和最佳治疗策略仍存在争议，临床过程尤其未知，因为报告的动脉瘤是首先偶然发现的，或动脉瘤破裂突然发生，他们立即得到治疗。
■一名68岁的男子在20年前接受了SRS，由于辐射引起的梭形小脑前下动脉瘤破裂，出现蛛网膜下腔出血（SAH）。他接受了母体动脉闭塞治疗，导致改良的Rankin量表等级2。该报告说明了通过回顾性磁共振成像评估在破裂前检测到动脉瘤形成的第一例。
■我们描述了动脉瘤快速进展和破裂的可能风险，专注于从SRS到动脉瘤形成的间隔。无论辐射剂量如何，SRS诱导的动脉瘤的形成时间怀疑从几年到几十年不等；然而，估计为假性动脉瘤的动脉瘤在几年内破裂的风险极高，即使尺寸很小。如果发现动脉瘤未破裂,不仅在预防SAH导致的不良预后方面有一些优势,而且在使用血运重建的可选治疗策略方面也有一些优势.长期年度随访，包括船只检查，不仅可以评估肿瘤状态，还可以早期发现任何血管病变。
■一名68岁的男子在20年前接受了SRS，由于辐射引起的梭形小脑前下动脉瘤破裂，出现蛛网膜下腔出血（SAH）。他接受了母体动脉闭塞治疗，导致改良的Rankin量表等级2。该报告说明了通过回顾性磁共振成像评估在破裂前检测到动脉瘤形成的第一例。
■我们描述了动脉瘤快速进展和破裂的可能风险，专注于从SRS到动脉瘤形成的间隔。无论辐射剂量如何，SRS诱导的动脉瘤的形成时间怀疑从几年到几十年不等；然而，估计为假性动脉瘤的动脉瘤在几年内破裂的风险极高，即使尺寸很小。如果发现动脉瘤未破裂,不仅在预防SAH导致的不良预后方面有一些优势,而且在使用血运重建的可选治疗策略方面也有一些优势.长期年度随访，包括船只检查，不仅可以评估肿瘤状态，还可以早期发现任何血管病变。
