Glioblastoma Presenting as Spontaneous Subarachnoid Hemorrhage: Technical Case Note of Combined Endovascular and Microsurgical Vision-Sparing Treatment

Darius Tan; Christopher Daly; Chris Xenos; Leon T Lai; Ronil V Chandra

doi:10.1016/j.wneu.2019.05.090

Glioblastoma Presenting as Spontaneous Subarachnoid Hemorrhage: Technical Case Note of Combined Endovascular and Microsurgical Vision-Sparing Treatment

World Neurosurg. 2019 Aug:128:426-430. doi: 10.1016/j.wneu.2019.05.090. Epub 2019 May 20.

Authors

Darius Tan¹, Christopher Daly², Chris Xenos², Leon T Lai³, Ronil V Chandra⁴

Affiliations

¹ Department of Neurosurgery, Monash Health, Monash University, Melbourne, Australia. Electronic address: Darius.Tan@monashhealth.org.
² Department of Neurosurgery, Monash Health, Monash University, Melbourne, Australia.
³ Department of Neurosurgery, Monash Health, Monash University, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia.
⁴ Department of Surgery, Monash University, Melbourne, Australia; Neuro-Interventional Radiology Unit, Department of Imaging, Monash Health, Melbourne, Australia.

PMID: 31121373
DOI: 10.1016/j.wneu.2019.05.090

Abstract

Background: Clinical utility of endovascular adjunct for tumor resection is well established, but its role in acute subarachnoid hemorrhage secondary to neoplastic pseudoaneurysm rupture has not been reported.

Case description: We discuss a 46-year-old patient presenting with a World Federation of Neurological Surgeons grade 1 subarachnoid hemorrhage from a ruptured posterior cerebral artery pseudoaneurysm due to glioblastoma tumor invasion.

Conclusions: A combined targeted endovascular embolization with microsurgical resection to spare the calcarine artery was used to avoid disruption to the optic radiation fiber pathway.

Keywords: Endovascular; Glioblastoma; Microsurgical; Subarachnoid hemorrhage.

Publication types

Case Reports

MeSH terms

Aneurysm, False / etiology
Brain Neoplasms / complications
Brain Neoplasms / diagnostic imaging
Brain Neoplasms / surgery*
Cerebral Angiography
Computed Tomography Angiography
Endovascular Procedures / methods*
Glioblastoma / complications
Glioblastoma / diagnostic imaging
Glioblastoma / surgery*
Humans
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Male
Microsurgery / methods*
Middle Aged
Neurosurgical Procedures / methods*
Organ Sparing Treatments
Posterior Cerebral Artery*
Subarachnoid Hemorrhage / diagnostic imaging
Subarachnoid Hemorrhage / etiology
Subarachnoid Hemorrhage / surgery*
Visual Pathways