Young-onset type 1 diabetes mellitus complicated by ruptured cerebral aneurysm and arteriovenous malformation: one case report.

Objective To report the diagnosis and treatment of a young patient with type 1 diabetes mellitus complicated by ruptured cerebral aneurysm and arteriovenous malformation (AVM), providing clinical strategies and management insights for handling critical and complex cerebrovascular diseases. Methods a...

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Publicado en:Chinese Journal of Contemporary Neurology & Neurosurgery Vol. 26; no. 3; pp. 324 - 332
Autores principales: LU, Li-chun, WANG, Chen, YIN, Xiang-yi, CHEN, Hua, HUANG, Qiang, ZHU, Wen-yu
Formato: case study diagnostic images pictorial tables/charts Journal Article
Publicado: Chinese Journal of Contemporary Neurology & Neurosurgery Mar2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2026
      vid: 26
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      pub: Chinese Journal of Contemporary Neurology & Neurosurgery
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        193030418
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        10.3969/j.issn.1672-6731.2026.03.016
        193030418
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        atl: Young-onset type 1 diabetes mellitus complicated by ruptured cerebral aneurysm and arteriovenous malformation: one case report.
      aug:
        au:
          LU, Li-chun
          WANG, Chen
          YIN, Xiang-yi
          CHEN, Hua
          HUANG, Qiang
          ZHU, Wen-yu
        affil: Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing University Medical School, Suzhou 215153, Jiangsu, China
      sug:
        subj:
          Diabetes Mellitus, Type 2 Complications
          Age of Onset
          Cerebral Aneurysm Diagnosis
          Arteriovenous Malformations Diagnosis
          Cerebral Aneurysm Surgery
          Female
          Young Adult
          Cerebral Hemorrhage
          Embolization, Therapeutic
          Hematoma Surgery
          Decompressive Craniectomy
          Endovascular Coil Embolization
          Female
      ab: Objective To report the diagnosis and treatment of a young patient with type 1 diabetes mellitus complicated by ruptured cerebral aneurysm and arteriovenous malformation (AVM), providing clinical strategies and management insights for handling critical and complex cerebrovascular diseases. Methods and Results A 19-year-old female with type 1 diabetes mellitus presented with acute intracerebral hemorrhage. Imaging revealed the hemorrhage was caused by rupture of multiple beaded aneurysms on a prominent lenticulostriate artery (LA) originating from the M1 segment of middle cerebral artery (MCA). This vascular pathology was accompanied by a caput medusae-like AVM (Spetzler-Martin grade IV) in the Sylvian fissure region. The neurosurgical team formulated and implemented a combined, staged therapeutic strategy. The first- stage procedure involved embolization of the lenticulostriate artery aneurysms, surgical evacuation of the hematoma, and decompressive craniectomy. This was followed by staged endovascular embolization of the AVM. Ultimately, curative embolization of all aneurysms and the AVM was successfully achieved while preserving the blood supply to normal brain tissue. Throughout the perioperative period, continuous glucose monitoring (CGM) was utilized to precisely titrate insulin dosage and maintain strict glycemic control. Conclusions For such rare cerebrovascular lesions characterized by complex anatomy and high-risk hemodynamics, a personalized, staged comprehensive strategy is crucial for achieving complete occlusion of the lesions while maximally preserving neurological function. The successful management of this case provides a referable multidisciplinary collaborative framework and clinical decision-making rationale for handling similar critical and complex cerebrovascular diseases.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: Chinese
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