RUPTURED DE-NOVO ANEURYSM INDUCED BY ETHYL 2-CYANOACRYLATE - CASE-REPORT

OBJECTIVE AND IMPORTANCE: We report a rare case of a ruptured de novo aneurysm induced by ethyl 2-cyanoacrylate. CLINICAL PRESENTATION: A 44 -year-old woman had undergone microvascular decompression for a right- sided facial spasm. The preoperative vertebral angiogram did not show any aneurysmal dilation. The right anteroinferior cerebellar artery, w hich was compressing the exit zone of the facial nerve, was detached a nd fixed to the dura mater with ethyl 2-cyanoacrylate. Nine years late r, the patient suffered a subarachnoid hemorrhage caused by the ruptur e of a newly developed aneurysm of the right anteroinferior cerebellar artery. INTERVENTION: The aneurysm was clipped 2 days after onset of the subarachnoid hemorrhage. It consisted of two bulges in the arteria l wall on the proximal side of the meatal loop. One bulge was stuck to the dura mater of the pyramis by ethyl 2-cyanoacrylate, which had bee n used in the microvascular decompression 9 years previously. CONCLUSI ON: This is the first reported clinical case of a de novo aneurysm ind uced by a cyanoacrylate adhesive. Ethyl 2-cyanoacrylate can damage the arterial wall and induce a de novo aneurysm.