prikaz prve stranice dokumenta Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note
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Scientific paper - Case study
Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note
Acta clinica Croatica, 59 (2020), 1; 166-172. https://doi.org/10.20471/acc.2020.59.01.21
Kalousek, Vladimir; Splavski, Bruno; Beroš, Vili; Čulo, Branimir; Vrban, Filip; Rotim, Ante; Rotim, Krešimir

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Kalousek, V., Splavski, B., Beroš, V., Čulo, B., Vrban, F., Rotim, A. & Rotim, K. (2020). Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note. Acta clinica Croatica, 59. (1), 166-172. doi: 10.20471/acc.2020.59.01.21

Kalousek, Vladimir, et al. "Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note." Acta clinica Croatica, vol. 59, no. 1, 2020, pp. 166-172. https://doi.org/10.20471/acc.2020.59.01.21

Kalousek, Vladimir, Bruno Splavski, Vili Beroš, Branimir Čulo, Filip Vrban, Ante Rotim and Krešimir Rotim. "Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note." Acta clinica Croatica 59, no. 1 (2020): 166-172. https://doi.org/10.20471/acc.2020.59.01.21

Kalousek, V., et al. (2020) 'Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note', Acta clinica Croatica, 59(1), pp. 166-172. doi: 10.20471/acc.2020.59.01.21

Kalousek V, Splavski B, Beroš V, Čulo B, Vrban F, Rotim A, and sur.. Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note. Acta clinica Croatica [Internet]. 2020 [cited 2024 November 18];59(1):166-172. doi: 10.20471/acc.2020.59.01.21

V. Kalousek, et al., "Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note", Acta clinica Croatica, vol. 59, no. 1, pp. 166-172, 2020. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:220:657355. [Accessed: 18 November 2024]

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Title (english)Large Aneurysm of Basilar Artery Tip Mimicking Midbrain Tumor and Causing Unilateral Obstructive Hydrocephalus: a Case Report and Technical Note
Title (croatian)Velika aneurizma vrška bazilarne arterije predstavljena kao mezencefalični tumor i uzrok jednostranog opstrukcijskog hidrocefalusa: prikaz slučaja i tehnička napomena
AuthorVladimir Kalousek
AuthorBruno Splavski https://orcid.org/0000-0002-4483-9364
AuthorVili Beroš
AuthorBranimir Čulo
AuthorFilip Vrban
AuthorAnte Rotim
AuthorKrešimir Rotim
Author's institution(Sestre milosrdnice University Hospital Center)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Neurology
Abstract (english)
Cerebral ventricular system is a sporadic location of intracranial aneurysms including those of basilar artery tip. Treatment of such aneurysms remains challenging regardless of endovascular or microsurgical techniques applied. Basilar tip aneurysm presenting as third ventricular mass is rarely associated with obstructive hydrocephalus, mimicking midbrain expansive process and urging precise diagnostics and prompt treatment. Hence, the management of such patients may be delicate, having an uncertain outcome. We report on a case of a patient with unilateral hydrocephalus caused by large basilar tip aneurysm mimicking a midbrain tumor. We also discuss different operative strategies influencing the outcome, including our own endovascular treatment technical modification. A 62-year-old female patient presented with slightly decreased cognition, minor gait disturbances and urinary incontinence. Computed brain tomography revealed a third ventricle mass with unilateral ventricular dilatation, indicating hypertensive obstructive hydrocephalus. Magnetic resonance and digital subtraction angiography identified the third ventricular mass as a large saccular basilar tip aneurysm. The patient was selected for endovascular treatment followed by cerebrospinal fluid derivation. After aneurysm endovascular occlusion and temporary external ventricular drainage, the symptoms diminished and ventricular dilatation decreased. On post-procedure day 10, the hydrocephalus was relieved and external drainage removed. The patient recovered fully and was discharged without neurological deficit. In conclusion, large basilar tip aneurysms associated with obstructive hydrocephalus are rare and best treated by a combination of endovascular obliteration and cerebrospinal fluid ventricular diversion. The possibility of such an aneurysm should always be considered on the differential diagnosis of cerebral ventricular growths.
Abstract (croatian)
Intrakranijske su aneurizme smještene unutar ventrikulskog sustava rijetke, uključujući one vrška bazilarne arterije. Njihovo je liječenje izrazito zahtjevno, neovisno o primijenjenoj endovaskularnoj ili mikrokirurškoj tehnici. Aneurizme bazilarnoga vrška koje se očituju kao ventrikulska ekspanzivna tvorba u području mezencefalona rijetko su povezane s razvitkom opstrukcijskoga hidrocefalusa, što zahtijeva preciznu dijagnostiku i žurno aktivno liječenje. Postupak je liječenja u ovakvih bolesnika iznimno složen, a ishod neizvjestan. U ovom radu opisujemo slučaj bolesnice s jednostranim hidrocefalusom uzrokovanim velikom aneurizmom bazilarnoga vrška, koja se diferencijalno dijagnostički očitovala kao mezencefalični tumor. Također raspravljamo o različitim mogućnostima operacijskog liječenja od utjecaja na ishod, uključujući i vlastitu tehničku modifikaciju endovaskularnog zahvata. Bolesnica u dobi od 62 godine zaprimljena je zbog blago sniženih kognitivnih sposobnosti, manjeg poremećaja u hodu i urinarne inkontinencije. Kompjutorska tomografija mozga upućivala je na ekspanzivnu tvorbu područja treće klijetke s jednostranim proširenjem postranične klijetke i posljedičnim hipertenzivnim hidrocefalusom. Magnetna rezonancija i digitalna suptrakcijska angiografija razotkrile su ekspanzivnu tvorbu kao veliku sakularnu aneurizmu bazilarnoga vrška. Bolesnica je podvrgnuta endovaskularnom liječenju sa susljednom derivacijom cerebrospinalnoga likvora. Simptomi i proširenje postranične klijetke su se umanjili nakon učinjene endovaskularne okluzije i privremene izvanjske ventrikulske drenaže. Desetog dana od operacije hidrocefalus se u cijelosti povukao pa je izvanjska drenaža uklonjena. Bolesnica se je u potpunosti oporavila te je otpuštena bez neurološkog ispada. Zaključujemo kako su aneurizme bazilarnoga vrška udružene s opstrukcijskim hidrocefalusom rijetke i kako ih je najpovoljnije liječiti kombinacijom endovaskularnog postupka i likvorske ventrikulske derivacije. Na mogućnost nastanka ovakve aneurizme treba uvijek pomisliti u diferencijalnoj dijagnostici cerebralnih ventrikulskih tvorba.
Keywords (english)
Keywords (croatian)
Languageenglish
Languagecroatian
Publication typeScientific paper - Case study
Publication statusPublished
Peer reviewPeer review - international
Publication versionPublished version
Journal titleActa clinica Croatica
Numberingvol. 59, no. 1, pp. 166-172
p-ISSN0353-9466
e-ISSN1333-9451
DOIhttps://doi.org/10.20471/acc.2020.59.01.21
URN:NBNurn:nbn:hr:220:657355
Publication2020
Document URLhttps://hrcak.srce.hr/242372
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) icon
Created on2024-06-25 09:55:39