Multiple fusiform intracranial aneurysms following curative radiation therapy for suprasellar germinoma

Case report

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✓ A 17-year-old girl died from the rupture of a large fusiform aneurysm of the terminal internal carotid artery. Autopsy revealed three other fusiform aneurysms originating from major cerebral arteries clearly within the ports of previously administered telecobalt radiation therapy. Five years prior to her death, a suprasellar germinoma was partially removed and the area was treated by radiation therapy via three ports. The original arteriograms showed a normal vascular tree. Repeat arteriograms, 3 years and 8 months before her death, demonstrated the aneurysms. The development of aneurysms following radiation damage of the arteries has been reported previously, but not in intracranial vessels.

Article Information

Address reprint requests to: Biagio Azzarelli, M.D., Department of Pathology, Division of Neuropathology, Indiana University School of Medicine, 635 Barnhill Drive, MS A142, Indianapolis, Indiana 46223.

© AANS, except where prohibited by US copyright law.

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Figures

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    Angiograms obtained on February 16, 1979. Left: Right internal carotid arteriogram. The supraclinoid portion of the internal carotid artery is normal. Right: Left vertebral arteriogram. The vertebrobasilar system is well opacified with reflux into the right vertebral artery. No aneurysmal dilatation is identified.

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    Angiograms obtained on November 10, 1982. Left: Right internal carotid arteriogram. Fusiform aneurysmal dilatation of the supraclinoid portion of the internal carotid artery is seen. Right: Left vertebral arteriogram. There is fusiform aneurysmal dilatation of the basilar artery. No reflux is seen into the right vertebral artery.

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    Postmortem photograph of the base of the brain. Arrows indicate the aneurysms of the right internal carotid, basilar, and right vertebral arteries.

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