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...
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| Format: | Article |
| Language: | English |
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Korean Society of Interventional Neuroradiology
2023-11-01
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| Series: | Neurointervention |
| Subjects: | |
| Online Access: | http://neurointervention.org/upload/pdf/neuroint-2023-00451.pdf |
| _version_ | 1797327088251830272 |
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| author | Sangil Park Boseong Kwon Deok Hee Lee Jae-Sung Ahn Yunsun Song |
| author_facet | Sangil Park Boseong Kwon Deok Hee Lee Jae-Sung Ahn Yunsun Song |
| author_sort | Sangil Park |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T06:33:24Z |
| format | Article |
| id | doaj.art-7aee54dab2a040e294f376be58d4a931 |
| institution | Directory Open Access Journal |
| issn | 2093-9043 2233-6273 |
| language | English |
| last_indexed | 2024-03-08T06:33:24Z |
| publishDate | 2023-11-01 |
| publisher | Korean Society of Interventional Neuroradiology |
| record_format | Article |
| series | Neurointervention |
| spelling | doaj.art-7aee54dab2a040e294f376be58d4a9312024-02-03T11:07:49ZengKorean Society of Interventional NeuroradiologyNeurointervention2093-90432233-62732023-11-0118320921310.5469/neuroint.2023.00451410Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a PseudoaneurysmSangil Park0Boseong Kwon1Deok Hee Lee2Jae-Sung Ahn3Yunsun Song4 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaHemangioblastomas (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.http://neurointervention.org/upload/pdf/neuroint-2023-00451.pdfaneurysmdural arteriovenous fistulahemangioblastoma |
| spellingShingle | Sangil Park Boseong Kwon Deok Hee Lee Jae-Sung Ahn Yunsun Song Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm Neurointervention aneurysm dural arteriovenous fistula hemangioblastoma |
| title | Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm |
| title_full | Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm |
| title_fullStr | Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm |
| title_full_unstemmed | Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm |
| title_short | Ruptured Medullary Hemangioblastoma Mimicking a Craniocervical Junction Dural Arteriovenous Fistula with a Pseudoaneurysm |
| title_sort | ruptured medullary hemangioblastoma mimicking a craniocervical junction dural arteriovenous fistula with a pseudoaneurysm |
| topic | aneurysm dural arteriovenous fistula hemangioblastoma |
| url | http://neurointervention.org/upload/pdf/neuroint-2023-00451.pdf |
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