Cerebral edema associated with Gliadel wafers: two case studies.
While the introduction of carmustine wafers (Gliadel wafers) into the tumor resection cavity has been shown to be a beneficial therapy for malignant glioma, it is recognized that clinically significant cerebral edema is a potential adverse effect. Following are two clinical case reports demonstrating profound cerebral edema associated with implantation of Gliadel wafers. As a result, one of these individuals had premature death. A brief literature review is provided to assist in explaining the mechanisms by which clinically significant cerebral edema may develop.
Weber
Emil L
EL
Tri-State Neurosurgical, Inc., Evansville, IN 47710, USA.
Goebel
Eric A
EA
D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D001672:Biocompatible Materials / Q000009:adverse effects*; D001929:Brain Edema / Q000209:etiology* / Q000473:pathology; D001932:Brain Neoplasms / Q000188:drug therapy; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects*; D003652:Decanoic Acids / Q000009:adverse effects*; D004343:Drug Implants; D005260:Female; D005910:Glioma / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011091:Polyesters / Q000009:adverse effects*
D018906:Antineoplastic Agents, Alkylating; D001672:Biocompatible Materials; D003652:Decanoic Acids; D004343:Drug Implants; D011091:Polyesters; C055401:decanedioic acid-4,4'-(1,3-propanediylbis(oxy))bis(benzoic acid) copolymer; D002330:Carmustine