Tucker A, Tsuji M, Yamada Y, Hanabusa K, Ukita T, Miyake H, Ohmura T. Arteriovenous malformation of the vestibulocochlear nerve. World J Clin Cases 2015; 3(7): 661-670 [PMID: 26244159 DOI: 10.12998/wjcc.v3.i7.661]
Corresponding Author of This Article
Adam Tucker, MD, Department of Neurological Surgery, Nishinomiya Kyoritsu Neurosurgical Hospital, 12-1 Imazu Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan. adamtucker75@hotmail.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Adam Tucker, Masao Tsuji, Yoshitaka Yamada, Kenichiro Hanabusa, Tohru Ukita, Hiroji Miyake, Takehisa Ohmura, Department of Neurosurgery, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo 663-8211, Japan
Author contributions: Tucker A and Tsuji M contributed to conception and design; Tucker A contributed to acquisition of data; Tucker A, Tsuji M and Yamada Y contributed to analysis and interpretation of data; Tucker A contributed to drafting the article; Tucker A and Yamada Y contributed to critically revising the article; all authors reviewed submitted version of the article; Tucker A approved the final version of the manuscript on behalf of all authors.
Institutional review board statement: As for the Institutional review board statement, the document was not applicable to our study and was not included.
Informed consent statement: As for the Informed consent statements, the document was not applicable to our study and was not included.
Conflict-of-interest statement: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adam Tucker, MD, Department of Neurological Surgery, Nishinomiya Kyoritsu Neurosurgical Hospital, 12-1 Imazu Yamanaka-cho, Nishinomiya, Hyogo 663-8211, Japan. adamtucker75@hotmail.com
Telephone: +81-798-332211 Fax: +81-798-332438
Received: September 29, 2014 Peer-review started: September 30, 2014 First decision: October 28, 2014 Revised: February 5, 2015 Accepted: April 16, 2015 Article in press: April 20, 2015 Published online: July 16, 2015 Processing time: 300 Days and 3.6 Hours
Abstract
We describe a rare case of an arteriovenous malformation (AVM) embedded in the vestibulocochlear nerve presenting with subarachnoid hemorrhage (SAH) treated by microsurgical elimination of the main feeding artery and partial nidus volume reduction with no permanent deficits. This 70-year-old woman was incidentally diagnosed 4 years previously with two small unruptured tandem aneurysms (ANs) on the right anterior inferior cerebral artery feeding a small right cerebellopontine angle AVM. The patient was followed conservatively until she developed sudden headache, nausea and vomiting and presented to our outpatient clinic after several days. Magnetic resonance imaging demonstrated findings suggestive of early subacute SAH in the quadrigeminal cistern. A microsurgical flow reduction technique via clipping between the two ANs and partial electrocoagulation of the nidus buried within the eighth cranial nerve provided radiographical devascularization of the ANs with residual AVM shunt flow and no major deficits during the 2.5 year follow-up. This is only the second report of an auditory nerve AVM. In the event of recurrence, reoperation or application of alternative therapies may be considered.
Core tip: Arteriovenous malformations (AVMs) originating within or impinging on cranial nerves are extremely rare, and there is an increased risk of hemorrhage in AVMs associated with aneurysms. The authors describe the second report of a patient with a vestibulocochlear nerve AVM who presented with subarachnoid hemorrhage. A discussion of the delicate diagnostic and therapeutic implications is presented.
