Intracranial vasospasm with delayed ischaemic deficit following epidermoid cyst resection.
Intracranial vasospasm following surgical removal of intracranial tumours is rare. To our knowledge there have been no previously reported cases of delayed vasospasm occurring post debulking of epidermoid cysts. We report a case in which vasospasm led to established cerebral infarction 2 weeks postoperatively. MRI and serial magnetic resonance angiography (MRA) reliably show initial multiple stenoses in the vertebral and internal carotid arteries followed by their spontaneous normalisation. MRA imaging is now of sufficient quality to enable it to be a safe and effective means of both looking for vasospasm and monitoring its resolution.
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Stroke Department, Nottingham City Hospital, Nottingham NG5 1PB, UK. darren.aw@gmail.com
Aldwaik
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Taylor
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Gaynor
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D000328:Adult; D002343:Carotid Artery, Internal / Q000503:physiopathology; D002528:Cerebellar Neoplasms / Q000601:surgery; D002530:Cerebellopontine Angle / Q000601:surgery; D002533:Cerebral Angiography / Q000379:methods; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology; D003251:Constriction, Pathologic / Q000175:diagnosis; D004814:Epidermal Cyst / Q000601:surgery; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis*; D020301:Vasospasm, Intracranial / Q000150:complications / Q000175:diagnosis*; D014711:Vertebral Artery / Q000503:physiopathology