Ultra early transient brain swelling following brief intraoperative ischaemia-reperfusion.
We describe a 50-year-old patient who developed acute transient hemispheric cerebral swelling, documented by computed tomography, following a temporary constriction (20 min) of the middle cerebral artery branches due to clipping of an aneurysm. Reporting of this postischaemic phenomenon has been limited and its mechanism and treatment remain unclear. A possible underlying process could be a postischaemic reactive vasodilatation leading to congestive hyperaemia. Hyperventilation and mannitol seem to be an effective treatment of this essentially 'benign' cerebral swelling. Copyright 1999 Harcourt Publishers Ltd.
Sakas
DE
Midland Centre for Neurosurgery and Neurology and Neuroscience Unit, Walsgrave Hospital, UK
Whitwell
HL
Watkins
RJ
Beale
DJ