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Case report
peer-reviewed

Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm



Abstract

Cerebellar hemangioblastomas are rare tumors of the neuraxis. Only seven cases of hemangioblastoma associated with a cerebral aneurysm have been reported. We report a case of a patient who presented with acute onset headache as a result of subarachnoid hemorrhage (SAH) and hydrocephalus. Radiographic workup revealed a hemangioblastoma with an intratumoral aneurysm. Preoperative cerebral angiography was performed for both embolization as well as characterization of the aneurysm. The patient underwent a suboccipital craniotomy for tumor resection. The patient’s postoperative course was unexpectedly complicated by delayed ischemic neurologic deficit secondary to flow-limiting left internal carotid artery vasospasm. We present a case report, review of the literature, and management considerations for patients who present with tumors and an associated ruptured aneurysm.



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Case report
peer-reviewed

Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm


Author Information

Connie Ju

Neurological Institute, Case Western School of Medicine

Christina H. Wright

Neurological Institute, University Hospitals Cleveland Medical Center

James Wright Corresponding Author

Neurological Institute, University Hospitals Cleveland Medical Center

Yifei Duan

Neurological Insitute, University Hospitals Cleveland Medical Center

Nicholas C. Bambakidis

Neurological Institute, University Hospitals Cleveland Medical Center


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm


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Case report
peer-reviewed

Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm

Connie Ju">Connie Ju, Christina H. Wright">Christina H. Wright, James Wright">James Wright , Yifei Duan">Yifei Duan, Nicholas C. Bambakidis">Nicholas C. Bambakidis

  • Author Information
    Connie Ju

    Neurological Institute, Case Western School of Medicine

    Christina H. Wright

    Neurological Institute, University Hospitals Cleveland Medical Center

    James Wright Corresponding Author

    Neurological Institute, University Hospitals Cleveland Medical Center

    Yifei Duan

    Neurological Insitute, University Hospitals Cleveland Medical Center

    Nicholas C. Bambakidis

    Neurological Institute, University Hospitals Cleveland Medical Center


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: August 24, 2017

    DOI

    10.7759/cureus.1606

    Cite this article as:

    Ju C, Wright C H, Wright J, et al. (August 24, 2017) Subarachnoid Hemorrhage Associated with Intratumoral Aneurysm Rupture within a Posterior Fossa Hemangioblastoma: The Importance of Continued Surveillance for Cerebral Vasospasm. Cureus 9(8): e1606. doi:10.7759/cureus.1606

    Publication history

    Received by Cureus: May 18, 2017
    Peer review began: June 19, 2017
    Peer review concluded: August 17, 2017
    Published: August 24, 2017

    Copyright

    © Copyright 2017
    Ju et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Cerebellar hemangioblastomas are rare tumors of the neuraxis. Only seven cases of hemangioblastoma associated with a cerebral aneurysm have been reported. We report a case of a patient who presented with acute onset headache as a result of subarachnoid hemorrhage (SAH) and hydrocephalus. Radiographic workup revealed a hemangioblastoma with an intratumoral aneurysm. Preoperative cerebral angiography was performed for both embolization as well as characterization of the aneurysm. The patient underwent a suboccipital craniotomy for tumor resection. The patient’s postoperative course was unexpectedly complicated by delayed ischemic neurologic deficit secondary to flow-limiting left internal carotid artery vasospasm. We present a case report, review of the literature, and management considerations for patients who present with tumors and an associated ruptured aneurysm.



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Create a free account to continue reading this article.

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Connie Ju

Neurological Institute, Case Western School of Medicine

Christina H. Wright

Neurological Institute, University Hospitals Cleveland Medical Center

James Wright

Neurological Institute, University Hospitals Cleveland Medical Center

For correspondence:
jmw171@case.edu

Yifei Duan

Neurological Insitute, University Hospitals Cleveland Medical Center

Nicholas C. Bambakidis

Neurological Institute, University Hospitals Cleveland Medical Center

Connie Ju

Neurological Institute, Case Western School of Medicine

Christina H. Wright

Neurological Institute, University Hospitals Cleveland Medical Center

James Wright

Neurological Institute, University Hospitals Cleveland Medical Center

For correspondence:
jmw171@case.edu

Yifei Duan

Neurological Insitute, University Hospitals Cleveland Medical Center

Nicholas C. Bambakidis

Neurological Institute, University Hospitals Cleveland Medical Center