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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 25:1116-1120, June-July 2004
© 2004 American Society of Neuroradiology

Case Report
SPINE

Fatal Ethibloc Embolization of Vertebrobasilar System following Percutaneous Injection into Aneurysmal Bone Cyst of the Second Cervical Vertebra

A. Peraud^a, J. M. Drake^a, D. Armstrong^c, D. Hedden^d, P. Babyn^c and G. Wilson^b

^a Division of Neurosurgery, Hospital for Sick Children, Toronto, Canada
^b Division of Pathology and Cardiovascular Research, Hospital for Sick Children, Toronto, Canada
^c Division of Diagnostic Imaging/Interventional Radiology, Hospital for Sick Children, Toronto, Canada
^d Division of Orthopedics, Hospital for Sick Children, Toronto, Canada

Address correspondence to Dr. James M. Drake Division of Neurosurgery, Room 1504, Hospital for Sick Children, 555 University Avenue, Toronto, Canada M5G 1X8

Summary: A 4-year-old boy developed progressive neck pain and an expansile osteogenic lesion of C2; the diagnosis was an aneurysmal bone cyst. An image-guided biopsy with 3D CT planning was performed followed by Ethibloc injection into the aneurysmal bone cyst. Subsequent CT and MR images demonstrated embolization material in the vertebrobasilar system, and the patient died of brain stem and cerebellar infarction 23 hours after the intervention. The course of events and technical considerations are discussed.