ABSTRACT
Objective: We report two patients with unruptured large aneurysms treated by overlapping stent-assisted coil embolization using low-profile visualized intraluminal support (LVIS) stents. Case Presentation: Case 1: An 80-year-old woman presented with abducens nerve palsy due to an internal carotid artery aneurysm. Case 2: A 75-year-old man presented with a partially thrombosed fusiform aneurysm in the vertebral artery (VA). Both patients were treated by overlapping LVIS stent-assisted coil embolization (overlapping LSACE). Digital subtraction angiography (DSA) a few months after embolization demonstrated complete occlusion of the aneurysm, although immediate angiography revealed dome filling. Conclusion: Overlapping LSACE may be an effective treatment method for aneurysms that are difficult to treat by standard SACE and result in better flow-diverting effects.
ABSTRACT
Spontaneous dissecting aneurysm of the extracranial internal carotid artery is uncommon, and simultaneous onset of multiple dissecting aneurysms is rare in patients without congenital or traumatic risk factors. A few reports suggest that extracranial internal carotid artery dissecting aneurysms can grow after SAH due to another intracranial dissecting aneurysm. The present report describes two cases in which gradual growth of unruptured dissecting aneurysm of extracranial internal carotid artery occurred after SAH due to ruptured dissecting aneurysm of the vertebral artery and in which carotid artery stenting was subsequently performed. A 42-year-old man was admitted to our hospital with SAH due to ruptured left vertebral artery dissecting aneurysm and was managed surgically. Dissecting aneurysm of the right extracranial internal carotid artery was found and showed gradual growth. The aneurysm was treated with a stent at 7 weeks after onset. In another case, a 47-year-old woman presented with SAH due to ruptured right vertebral artery dissecting aneurysm and was managed surgically. Concomitant left extracranial internal carotid artery dissecting aneurysm was found and showed gradual growth. The aneurysm was treated with stent and coils. These are rare cases of multiple dissecting aneurysms that originated from different arteries simultaneously and that showed growth after SAH.
Subject(s)
Carotid Artery, Internal, Dissection/pathology , Carotid Artery, Internal/pathology , Subarachnoid Hemorrhage/pathology , Adult , Aneurysm, Ruptured/complications , Aneurysm, Ruptured/pathology , Aneurysm, Ruptured/surgery , Carotid Artery, Internal, Dissection/etiology , Carotid Artery, Internal, Dissection/surgery , Disease Progression , Female , Humans , Male , Middle Aged , Neurosurgical Procedures/methods , Stents , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/surgery , Treatment Outcome , Vertebral Artery Dissection/complications , Vertebral Artery Dissection/pathology , Vertebral Artery Dissection/surgeryABSTRACT
Intracranial meningioma with intratumor metastasis have been occasionally reported. However, to our knowledge, there are almost no reports of malignant tumors initially discovered due to metastasis to meningioma. A 74-year-old woman presented with amnesia. Magnetic resonance imaging showed a well-defined mass arising from falcotentorial junction and homogeneous enhancement. Histopathologic findings showed that the mass was a meningothelial meningioma, with the majority of the tumor cells propagating in sheets, however, a single area in the tumor tissue showed the different histology. Immunohistologically, cytokeratin 7 (CK7), thyroid transcription factor-1 (TTF-1), and Napsin were positive, which led to lung adenocarcinoma metastasis. Furthermore, E-cadherin staining showed a 70% positive rate in lung adenocarcinoma and 30% in meningothelial meningioma. We report our experiences regarding a case of lung cancer that metastasized to intracranial meningioma and its clinical presentation and pathology.
