title: Chronic Phase Intracranial Hemorrhage Caused by Ruptured Pseudoaneurysm Induced by Carmustine Wafer Implantation for Insulo-opercular Anaplastic Astrocytoma: A Case Report.
abstract: Carmustine wafers improve the survival of patients with high-grade gliomas, but several adverse events have been reported. A 42-year-old man with left Insulo-opercular anaplastic astrocytoma developed a massive intra-cavital hematoma with subarachnoid hemorrhage caused by ruptured pseudoaneurysm of the left middle cerebral artery (MCA) adjacent to the site of carmustine wafers implanted 6 months previously. Intraoperative finding demonstrated a dissection of the insular portion of the MCA, and pathological examination identified the resected pseudoaneurysm. This case demonstrates that carmustine wafers can cause changes in local vessels. Therefore, implantation of carmustine wafers near to important vessels passing close to the resection cavity should be considered with great caution.
authors.affiliation: Department of Neurosurgery, Kitasato University School of Medicine.
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Sato
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Dan
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamamoto
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Miyajima
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hara
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
mesh_terms: D000328:Adult; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000601:surgery; D001254:Astrocytoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002533:Cerebral Angiography; D002908:Chronic Disease; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging; D014057:Tomography, X-Ray Computed