Limits...
Ruptured venous aneurysm of cervicomedullary junction.

Aggarwal A, Salunke P, Futane S, Mathuriya SN, Kumar A, Mukherjee KK, Radotra BD - Surg Neurol Int (2014)

Bottom Line: During surgery, a saccular pliable structure approx. 1.5 × 1 cm was found in the subarachnoid space that was clipped and excised.The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality.Surgically clipping and excision remains the treatment of choice for such lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.

ABSTRACT

Background: Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM) or developmental venous anomaly (DVA). However, isolated venous aneurysm is unusual.

Case description: We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH). Digital substraction angiography (DSA) revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ). Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 × 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein.

Conclusion: This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM) of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.

No MeSH data available.


Related in: MedlinePlus

(a) NCCT Head showing SAH and IVH, (b) 3D CT angiography seen from anterior aspect and above showing dilated vascular structure (shown by arrow) near posterior CVJ, (c and d) CT angiography coronal and sagittal reconstruction, showing dilated vascular structure (shown by arrow) near CVJ, (e) DSA in arterial phase does not show any aneurysm, (f) DSA in early venous and late arterial phase showing venous aneurysmal dialatation (arrow), (g and h) postoperative DSA showing nonfilling of aneurysm both in the arterial phase and (g) venous phase, (h) Aneurysm clip is seen
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3927081&req=5

Figure 1: (a) NCCT Head showing SAH and IVH, (b) 3D CT angiography seen from anterior aspect and above showing dilated vascular structure (shown by arrow) near posterior CVJ, (c and d) CT angiography coronal and sagittal reconstruction, showing dilated vascular structure (shown by arrow) near CVJ, (e) DSA in arterial phase does not show any aneurysm, (f) DSA in early venous and late arterial phase showing venous aneurysmal dialatation (arrow), (g and h) postoperative DSA showing nonfilling of aneurysm both in the arterial phase and (g) venous phase, (h) Aneurysm clip is seen

Mentions: A 52-year-old male with no known previous comorbidities presented with sudden onset headache, vomiting, and transient loss of consciousness. Patient was conscious but disoriented with no focal motor/sensory deficit. Computed tomography (CT) head revealed subarachnoid hemorrhage (SAH) with intraventricular hemorrhage (IVH) [Figure 1a].


Ruptured venous aneurysm of cervicomedullary junction.

Aggarwal A, Salunke P, Futane S, Mathuriya SN, Kumar A, Mukherjee KK, Radotra BD - Surg Neurol Int (2014)

(a) NCCT Head showing SAH and IVH, (b) 3D CT angiography seen from anterior aspect and above showing dilated vascular structure (shown by arrow) near posterior CVJ, (c and d) CT angiography coronal and sagittal reconstruction, showing dilated vascular structure (shown by arrow) near CVJ, (e) DSA in arterial phase does not show any aneurysm, (f) DSA in early venous and late arterial phase showing venous aneurysmal dialatation (arrow), (g and h) postoperative DSA showing nonfilling of aneurysm both in the arterial phase and (g) venous phase, (h) Aneurysm clip is seen
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927081&req=5

Figure 1: (a) NCCT Head showing SAH and IVH, (b) 3D CT angiography seen from anterior aspect and above showing dilated vascular structure (shown by arrow) near posterior CVJ, (c and d) CT angiography coronal and sagittal reconstruction, showing dilated vascular structure (shown by arrow) near CVJ, (e) DSA in arterial phase does not show any aneurysm, (f) DSA in early venous and late arterial phase showing venous aneurysmal dialatation (arrow), (g and h) postoperative DSA showing nonfilling of aneurysm both in the arterial phase and (g) venous phase, (h) Aneurysm clip is seen
Mentions: A 52-year-old male with no known previous comorbidities presented with sudden onset headache, vomiting, and transient loss of consciousness. Patient was conscious but disoriented with no focal motor/sensory deficit. Computed tomography (CT) head revealed subarachnoid hemorrhage (SAH) with intraventricular hemorrhage (IVH) [Figure 1a].

Bottom Line: During surgery, a saccular pliable structure approx. 1.5 × 1 cm was found in the subarachnoid space that was clipped and excised.The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality.Surgically clipping and excision remains the treatment of choice for such lesion.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, PGIMER, Chandigarh, India.

ABSTRACT

Background: Ruptured venous aneurysm is often seen with arterio-venous malformation (AVM) or developmental venous anomaly (DVA). However, isolated venous aneurysm is unusual.

Case description: We present a case of ruptured venous aneurysm that presented with subarachnoid hemorrhage (SAH) and intraventricular hemorrhage (IVH). Digital substraction angiography (DSA) revealed a saccular contrast filling pouch in the left lateral aspect of cervicomedullary junction (CMJ). Endovascular intervention was not a viable option. During surgery, a saccular pliable structure approx. 1.5 × 1 cm was found in the subarachnoid space that was clipped and excised. There were no arterial feeders, no evidence of surrounding AVM, and no dilated perimedullary vein.

Conclusion: This is perhaps the first reported case of ruptured venous aneurysm (without associated AVM) of CMJ, which was successfully managed surgically. The possible etiologies remain an unnoticed head trauma or a congenital vessel wall abnormality. Surgically clipping and excision remains the treatment of choice for such lesion.

No MeSH data available.


Related in: MedlinePlus