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Pial brainstem artery arteriovenous malformation with flow-related intracanalicular aneurysm masquerading as vestibular schwannoma: illustrative case

David D. Liu, David B. Kurland, Aryan Ali, John G. Golfinos, Erez Nossek, and Howard A. Riina

can prevent worsening seventh/eighth nerve symptoms or more devastating SAH. On imaging, a T1 and T2 hypointense cerebellopontine angle lesion with postgadolinium enhancement is usually VS, but the differential diagnosis also includes the much less common meningioma or vascular lesion, 6 including aneurysm or cavernous malformation. Although the pretest probability of an intracanalicular aneurysm is extremely low and thus not all such lesions necessitate angiography, some imaging features may offer clues that an IAC lesion is not a VS. For example, the absence of

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Delayed symptomatic cerebral vasospasm following vestibular schwannoma resection: illustrative case

Paurush Pasricha, Alay V Khandhar, and Basant K Misra

excision, and in 1 of the cases, the authors suggested a relative paucity of CSF in the cisterns as a predisposing factor for vasospasm. 6 , 7 Other than the 5 cases of schwannoma, we identified 8 cases of posterior fossa extraaxial tumor excisions leading to cerebral vasospasms. Tumors in these cases included 4 meningiomas and 1 each of epidermoid cyst, medulloblastoma, chordoma, and chondrosarcoma. 1 , 19–22 Of a total 13 cases of posterior fossa extraaxial tumors that led to cerebral vasospasm, perioperative hemorrhage or imaging confirmation of SAH was reported in