• World Neurosurg · May 2018

    Case Reports

    A case of subarachnoid hemorrhage from ruptured oncotic fusiform aneurysms from choriocarcinoma metastasis treated with aneurysmectomy and vessel reconstruction.

    • Yuichi Ito, Yoshio Araki, Takashi Izumi, Sho Okamoto, Masaaki Kimura, and Toshihiko Wakabayashi.
    • Department of Neurosurgery, Nagoya Ekisaikai Hospital, Nakagawa-ku, Nagoya, Aichi, Japan.
    • World Neurosurg. 2018 May 1; 113: 98-102.

    BackgroundOncotic aneurysm is a rare condition with a high mortality rate. Because no consensus has been reached regarding therapeutic strategy for ruptured oncotic aneurysm, treatment remains challenging.Case DescriptionA 35-year-old woman developed sudden onset of severe headache. Computed tomography showed subarachnoid hemorrhage and cerebral angiography revealed 2 fusiform aneurysms in the distal portion of the left middle cerebral artery. Aneurysmectomy with vessel reconstruction using a superficial temporal artery graft was performed to maintain blood flow to the distal middle cerebral artery. Pathologic examination of the aneurysm and wall of the resected recipient middle cerebral artery showed infiltrating trophoblasts. Immunostaining for human chorionic gonadotropin was positive in the aneurysm specimen. On the basis of an elevated concentration of serum human chorionic gonadotropin, choriocarcinoma with ruptured intracranial oncotic aneurysms was diagnosed. After further systemic examination for carcinoma, chemotherapy was initiated.ConclusionsAneurysmectomy, resection of the parent artery with irregular walls and reconstruction to the distal recipient artery with normal intima should be considered to secure patency of the anastomosis and prevent the recurrence of oncotic aneurysm. Subsequent chemotherapy is essential to prevent carcinomatous meningitis and disease progression.Copyright © 2018 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.