Bilateral basal ganglia infarction following resection of a right parietal parasagittal dural tumour requiring sinus repair -- an atypical complication of an atypical venous drainage.
The case of a 68-year old woman who underwent surgery for a right parietal parasagittal dural tumour is reported. In the preoperative angiography the straight sinus failed to show. During tumour resection the lateral wall of the parietal superior sagittal sinus was opened and reconstructed. Postoperatively, the patient remained unresponsive. A computerized tomography scan revealed bilateral infarction of the basal ganglia. Angiography showed an occlusion of the superior sagittal sinus with hypervolaemia of the deep venous system. The patient did not recover. We conclude that patency of the superficial venous drainage system can be mandatory for drainage of the basal ganglia in cases with deep venous obstruction. To our knowledge, this is an extremely rare complication of neurosurgery in cortical supratentorial areas.
von Eckardstein
Kajetan L
KL
Department of Neurosurgery, HELIOS Klinikum Berlin, Klinikum Buch, Hobrechtsfelder Chaussee 96, 13125 Berlin, Germany. keckardstein@berlin.helios-kliniken.de
Youssef
Farid
F
Hoch
Hans-Heinrich
HH
Kiwit
Jurgen Cw
JC
D000368:Aged; D001479:Basal Ganglia / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D003392:Cranial Sinuses / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures / Q000379:methods*; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed