Arteriovenous malformations (AVMs) associated with intracranial aneurysms are on uncommon condition.Twelve cases of AVMs associated with cerebral aneurysms were reported in a series of 180 AVMs (6.7%) over the last 17 years, six of these were in the posterior fossa. Most all showed a hemodynamic correlation between the AVM and the aneurysm.AVMs and aneurysms should be treated surgically in one operation, however if this is not possible, we should take care of the hemodynamic change induced by the operative procedure. In the case of aneurysm rupture or unknown origin of hemorrhage, the aneurysm should be treated prior to the AVM.With conservative therapy, we observed enlargement of the aneurysm size in one patient, however there was no incidence of rebleeding.
Primary myxoma of the central nervous system is an extremely rare tumor arising from cells of primitive mesenchymal origin. Only two cases of primary intracranial myxoma have been described previously. We report a patient with a primary myxoma originating from the right frontoparietal convexity dura, which we studied in detail with diagnostic imaging and pathological analysis.A female adolescent presented to the emergency department with a 3-day history of mild headache, abdominal pain, and intermittent left-sided focal motor seizures. Neurological examination was remarkable for left leg hyperreflexia and difficulty with tandem gait. Cranial computed tomography and magnetic resonance imaging demonstrated an inhomogeneously enhancing mass in the right frontoparietal region.A right frontoparietal craniotomy was performed. During surgery, a tumor appearing similar to a typical convexity meningioma was completely removed along with the dural attachment.The patient had an uneventful recovery and returned to normal activity. Primary intracranial myxoma should be distinguished from other meningeal tumors and metastatic cardiac myxoma by appropriate pathological analysis and cardiac evaluation. A circumscribed myxoma completely excised with adequate dural margin carries a good prognosis for surgical cure.
OBJECTIVE AND IMPORTANCE: Primary myxoma of the central nervous system is an extremely rare tumor arising from cells of primitive mesenchymal origin. Only two cases of primary intracranial myxoma have been described previously. We report a patient with a primary myxoma originating from the right frontoparietal convexity dura, which we studied in detail with diagnostic imaging and pathological analysis. CLINICAL PRESENTATION: A female adolescent presented to the emergency department with a 3-day history of mild headache, abdominal pain, and intermittent left-sided focal motor seizures. Neurological examination was remarkable for left leg hyperreflexia and difficulty with tandem gait. Cranial computed tomography and magnetic resonance imaging demonstrated an inhomogeneously enhancing mass in the right frontoparietal region. INTERVENTION: A right frontoparietal craniotomy was performed. During surgery, a tumor appearing similar to a typical convexity meningioma was completely removed along with the dural attachment. CONCLUSION: The patient had an uneventful recovery and returned to normal activity. Primary intracranial myxoma should be distinguished from other meningeal tumors and metastatic cardiac myxoma by appropriate pathological analysis and cardiac evaluation. A circumscribed myxoma completely excised with adequate dural margin carries a good prognosis for surgical cure.
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