[Delayed vasospasm complicated with the postoperative stage of the meningioma: a case report].
Though it has been reported infrequently that delayed vasospasm may appear in head-injured patients, it is rather rarer to see it as a complication arising from tumor removal. Such a case was presented and gave rise to speculation of a possible underlying pathophysiology. A 46-year-old female patient was admitted to our neurosurgical service, complaining of aching pain in the forehead. No neurological deficits were elicited on admission. CT scans as well as MR imagings confirmed the existence of a left sphenoid wing meningioma whose gross total removal was accomplished. She was doing well till the 3rd postoperative day, when she developed transcortical motor aphasia. 123I-IMP SPECT revealed low perfusion over the left middle cerebral artery territory, and CT scans also showed low density areas in the same region, including the putamen, corona radiata and temporal lobe on the left side. Left carotid angiography disclosed diffuse arterial narrowings involving C1, C2, A1 and M1 portions. The authors suspect that indirect injury to those arteries and/or some kind of inflammatory process might have played a role.
Shirasaka
A
A
Department of Neurosurgery, Hamamatsu University School of Medicine, Japan.
Ninchoji
T
T
Uemura
K
K
Shinohara
Y
Y
Kuwahara
T
T
Yamazaki
K
K
D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology*; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed