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Giant vertebro-basilar aneurysm: an unusual cerebello-pontine angle lesion

Published online by Cambridge University Press:  07 April 2006

Sudhakiran Kalavagunta ,
Apostolos Karkanevatos  and
Andrew C Swift
Sudhakiran Kalavagunta
Affiliation:
Department of Otorhinolaryngology, University Hospital Aintree, Liverpool, UK Department of Otorhinolaryngology, Saad Specialist Hospital, Al-Khobar, KSA
Apostolos Karkanevatos
Affiliation:
Department of Otorhinolaryngology, University Hospital Aintree, Liverpool, UK
Andrew C Swift
Affiliation:
Department of Otorhinolaryngology, University Hospital Aintree, Liverpool, UK
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Abstract

Acoustic neuromas (vestibular schwannomas) comprise more than 90 per cent of all cerebello-pontine angle (CPA) lesions. We present a rare case of a giant vertebro-basilar aneurysm presenting as a CPA lesion. The general condition of the patient precluded the completion of the magnetic resonance (MR) sequences. The clinical and limited radiological results (T2 images alone, the features of which were not specific) initially did not lead to a specific diagnosis. To obtain further radiological information a computed tomography (CT) scan with contrast was performed and this revealed the lesion to be an aneurysm. The diagnostic difficulties and the treatment dilemmas of such a lesion are discussed. The importance of fine, axial, post-contrast CT arteriography with three-dimensional reconstruction, MR angiography and digital subtraction angiography are highlighted. The limitations of MR imaging in patients with CPA lesions are discussed.

Keywords

Cerebello-pontine AngleNeuromaAcousticIntracranial AneurysmTomographyXray ComputedMagnetic Resonance Imaging
Type
Online Only Radiology in Focus
Information
The Journal of Laryngology & Otology , Volume 120 , Issue 2 , February 2006 , pp. 1 - 3 , e8
Copyright
© 2005 JLO (1984) Limited

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Footnotes

Presented as a poster at the Fourth International Conference on Vestibular Schwannoma and Other CPA Lesions, 13–17 July 2003, Cambridge, UK