PMC9949606_01
MRI features of the patient before and after craniotomy. (A) Axial T1-weighted MRI with contrast showing a 1.5 cm*1.2 cm*1.3 cm right-sided vestibular schwannoma before craniotomy surgery; (B) Postoperative axial T1-weighted MRI with contrast revealing total resection of tumor; (C) Postoperative axial T2-weighted MRI showing no ischemic lesion in the right AICA territory.
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F1
The volume of tumor shrunk from 2.1 cm*1.9 cm*1.4 cm to 1. 5cm*1.2 cm*1.3 cm after GKS treatment, and follow-up magnetic resonance imaging (MRI) showed stable features until this admission (Figure 1A). MRI performed on postoperative day 3 revealed gross total resection of tumor (Figure 1B) and no ischemic lesion in the right AICA feeding area (Figure 1C).
Intraoperative images of dissecting aneurysm arising from the main trunk of AICA (yellow arrows). (A) Intraoperative image showing a fusiform-like aneurysm with smooth adventitia embedded in the schwannoma. (B) The aneurysm arose from the main trunk of AICA. (C) The components of the aneurysm were identified as organized thrombus after incising the wall of the aneurysm. (D) AICA was preserved with clipping.
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F2
After removal of the superficial tumor, a fusiform-like aneurysm with smooth adventitia showed up within the tumor (Figure 2A). The aneurysm arose from the main trunk of the AICA and adhered the tumor tightly (Figure 2B). The components in the aneurysm were identified as organized thrombus (Figure 2C). After removing most of the components, we used a small curved clip to outline the edge of the residual aneurysm wall, to avoid sacrificing the AICA (Figure 2D).