Fatal delayed post-operative cerebral venous thrombosis after excision of hypoglossal nerve schwannoma.
Lower cranial nerve schwannomas are rare tumours. We present a 35 year old female patient who had a lower cranial nerve schwannoma with both intracranial and extracranial components. The internal jugular vein was injured during the dissection of the extracranial portion of the tumour. Ligation of the internal jugular vein is not associated with significant post-operative complications. Our patient however, developed retrograde cortical venous thrombosis on the 14(th) post-operative day resulting in multiple areas of haemorrhagic venous infarction with raised intracranial pressure. Such a delayed contiguous cortical venous thrombosis has not been reported. We present this report to highlight this event and to outline the probable causes for the same.
Garg
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Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Banglore, India.
Sampath
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S
D000328:Adult; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020437:Hypoglossal Nerve Diseases / Q000473:pathology / Q000601:surgery*; D007091:Image Processing, Computer-Assisted; D020766:Intracranial Embolism / Q000473:pathology*; D019586:Intracranial Hypertension / Q000473:pathology; D007431:Intraoperative Complications / Q000601:surgery; D007601:Jugular Veins / Q000293:injuries / Q000473:pathology*; D008026:Ligation; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D018365:Neoplasm, Residual / Q000473:pathology; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery*; D010690:Phlebography; D011183:Postoperative Complications / Q000473:pathology*; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000473:pathology*