| Subarachnoid Hemorrhage after Gamma Knife Radiosurgery for a Vestibular Schwannoma : A Case Report |
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Tae-Won Yoo, Eun-Suk Park, Do-Hoon Kwon, Chang-Jin Kim |
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Departments of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
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| Abstract |
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Aneurysm formation after Gamma Knife radiosurgery (GKRS) for a vestibular schwannoma is extremely rare, and there have been few reports of subarachnoid hemorrhage (SAH) after GKRS for a vestibular schwannoma. A 62-year-old woman underwent GKRS for a vestibular schwannoma. Eight years after GKRS, she suffered sudden onset of headache. Computed tomography (CT) revealed diffuse subarachnoid hemorrhage in right cerebellar pontine angle (CPA) cistern, basal cistern, right sylvian fissure and both cerebral convexities. Left vertebral arteriogram showed about 9 x 6mm sized aneurysm at the right distal anterior inferior cerebellar artery (AICA). Coil embolization of aneurysm using Guglielmi Detachable Coils (GDC, Boston Scientific Neurovascular, Fremont, CA, USA) was performed. However, follow-up brain CT images showed that hydrocephalus with intraventricular hemorrhage (IVH) was increased and acute infarction in both cerebellar hemisphere was newly appeared. Extraventricular drainage (EVD) and decompressive suboccipital craniectomy was performed. Six months later, the patient recovered and underwent rehabilitation. |
| Key Words:
Vestibular schwannoma, Gamma knife radiosurgery, Anterior inferior cerebellar artery, Radiation induced aneurysm, Subarachnoid hemorrhage. |
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