Acute vasospasm following transcallosal resection of a xanthogranulomatous colloid cyst of the 3rd ventricle.
We present the first case of a 57 year old man who developed severe, acute vasospasm following transcallosal resection of an unusual, xanthogranulomatous colloid cyst. The 16 year history of growth of this cyst may have resulted in its unusual pathology, and the subsequent vasospastic reaction to its excision. We discuss the potential pathological relationship between the inflammatory nature of the cyst, chemical meningitis and vasospasm, and what this implies about vasospasm in general. The severe, life-threatening vasospasm affected all four major vessels and required aggressive management by endovascular injection of nimodipine and angioplasty, with good recovery. The case illustrates a previously undescribed sequel of surgery for this condition, demonstrates an effective treatment and offers possible insights into the pathogenesis of vasospasm.
Webb
A J S
AJ
Department of Clinical Neurology, Oxford University, Level 6, West Wing, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, United Kingdom. alastair.webb@doctors.org.uk
Gillies
M J
MJ
Cadoux-Hudson
T A
TA
D017130:Angioplasty; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D020863:Central Nervous System Cysts / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D002533:Cerebral Angiography; D002551:Cerebral Ventricle Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D003337:Corpus Callosum / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006099:Granuloma / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008582:Meningitis, Aseptic / Q000150:complications / Q000473:pathology; D001523:Mental Disorders / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009553:Nimodipine / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology* / Q000523:psychology; D020542:Third Ventricle / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D020301:Vasospasm, Intracranial / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology
D002121:Calcium Channel Blockers; D009553:Nimodipine