Journal of Cerebrovascular and Endovascular Neurosurgery

  • 제26권2호
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  • Pages.187-195
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  • 2024
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  • 2234-8565(pISSN)
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  • 2287-3139(eISSN)
대한뇌혈관외과학회 (Korean Society of Cerebravascular Surgeons)
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Symptomatic perianeursymal cyst development 20 years after endovascular treatment of a ruptured giant aneurysm: Case report and updated review

  • Amy J. Wang (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Justin E. Vranic (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Robert W. Regenhardt (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Adam A. Dmytriw (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Christine K. Lee (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Cameron Sadegh (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • James D. Rabinov (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School) ;
  • Christopher J. Stapleton (Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School)
  • 투고 : 2023.01.30
  • 심사 : 2023.08.31
  • 발행 : 2024.06.30
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초록

Perianeurysmal cysts are a rare and poorly understood finding in patients both with treated and untreated aneurysms. While the prior literature suggests that a minority of perianeurysmal cysts develop 1-4 years following endovascular aneurysm treatment, this updated review demonstrates that nearly half of perianeurysmal cysts were diagnosed following aneurysm coiling, with the other half diagnosed concurrently with an associated aneurysm prior to treatment. 64% of perianeurysmal cysts were surgically decompressed, with a 39% rate of recurrence requiring re-operation. We report a case of a 71-year-old woman who presented with vertigo and nausea and was found to have a 3.4 cm perianeurysmal cyst 20 years after initial endovascular coiling of a ruptured giant ophthalmic aneurysm. The cyst was treated with endoscopic fenestration followed by open fenestration upon recurrence. The case represents the longest latency from initial aneurysm treatment to cyst diagnosis reported in the literature and indicates that the diagnosis of perianeurysmal cyst should remain on the differential even decades after treatment. Based on a case discussion and updated literature review, this report highlights proposed etiologies of development and management strategies for a challenging lesion.

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참고문헌

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