De Novo Aneurysm Formation After Stereotactic Radiosurgery of a Residual Arteriovenous Malformation: Case Report
Paul P. Huanga,
Toshifumi Kamiryoa and
P. Kim Nelsona
a From the Departments of Neurosurgery (P.P.H.) and Radiology (Interventional Neuroradiology) (T.K., P.K.N.), New York University Medical Center, New York, NY.
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FIG 1. Arterial phase image (frontal projection) from a digital subtraction angiogram of the right internal carotid artery acquired at the time of radiosurgical planning. Note the small residual nidus (curved arrow) of a left posterior frontal AVM. The nidus is supplied by a posterior internal frontal branch of the left anterior cerebral artery and drains into the left thalamostriate vein (thin arrow). Owing to a hypoplastic left A1 segment, the AVM was not well visualized by left internal carotid artery angiography.
FIG 2. Right internal carotid artery angiogram (frontal projection) 9 months later disclosing the interval development of a small paranidal aneurysm (arrowhead)
FIG 3. Superselective digital subtraction angiogram (frontal projection) obtained prior to embolization of the aneurysm and nidus with n-butyl-cyanoacrylate. The microcatheter tip is indicated by the curved arrow.
FIG 4. Postembolization right internal carotid artery angiogram (frontal projection) confirming occlusion of the aneurysm
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