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

• Published in: World neurosurgery Vol. 128; pp. 426 - 430
• Main Authors: Tan, Darius, Daly, Christopher, Xenos, Chris, Lai, Leon T., Chandra, Ronil V.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2019
• Subjects: Aneurysm, False - etiology; Brain Neoplasms - complications; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - surgery; Cerebral Angiography; Computed Tomography Angiography; Endovascular; Endovascular Procedures - methods; Glioblastoma; Glioblastoma - complications; Glioblastoma - diagnostic imaging; Glioblastoma - surgery; Humans; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Microsurgery - methods; Microsurgical; Middle Aged; Neurosurgical Procedures - methods; Organ Sparing Treatments; Posterior Cerebral Artery; Subarachnoid hemorrhage; Subarachnoid Hemorrhage - diagnostic imaging; Subarachnoid Hemorrhage - etiology; Subarachnoid Hemorrhage - surgery; Visual Pathways; Subarachnoid hemorrhage; Endovascular; Glioblastoma; MCA; GB; SAH; Microsurgical; PCA
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.05.090

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