[Cerebral aneurysms associated with von Recklinghausen neurofibromatosis: report of two cases].

The authors reported two cases of aneurysms associated with von Recklinghausen's neurofibromatosis. The first case, a 60-year-old woman was referred to our hospital because of disturbance of consciousness and right hemiparesis of acute onset. On admission, she was almost alert but developed right hemiparesis and lower cranial nerve palsy. Computed tomographic (CT) scanning and magnetic resonance imaging (MRI) demonstrated a huge mass compressing the brain stem and another mass lesion in the suprasellar cistern. Cerebral angiography disclosed left vertebral and left internal carotid artery giant aneurysms. Since she suffered respiratory distress because of aspiration pneumonia, conservative therapy was carried out. However, she developed cardiac arrest suddenly and died fourteen days after admission. On autopsy, it was shown that the left sided medulla oblongata had necrosis due to compression by the giant aneurysm and that the hemorrhagic infarction of the left cerebellar hemisphere was caused by a thrombus from the giant aneurysm of the left vertebral artery. The second case, a 40-year-old woman presented a disturbance of consciousness. A CT scanning demonstrated subarachnoid hemorrhage with a thick hematoma in the left sylvian fissure. An aneurysm at the junction of the right internal carotid artery and the posterior communicating artery was found, while the left middle cerebral artery was shown to be normal on cerebral angiography. Additionally an arteriovenous fistula of the left vertebral artery was found. Although no aneurysm was seen in the territory of the left internal carotid artery, left sided craniotomy was performed based on the CT findings.(ABSTRACT TRUNCATED AT 250 WORDS)