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Vasospasm following tumor removal: report of 5 cases

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Abstract

Cerebral vasospasm is a clinical/angiographical condition frequently observed after a subarachnoid hemorrhage due to the rupture of an intracranial aneurysm. Twenty cases of vasospasm observed after the removal of cerebral tumors have been reported in the literature; we here report on a further five. The time of onset of symptomatic vasospasm was 3–7 days after surgery; three of the patients died of an ischemic event induced by the vasospasm and two survive. Although no angiographic confirmation was obtained in our cases, serial transcranial Doppler (TCD) flow velocities were always high. It is suggested that the TCD-revealed accumulation of blood in the basal cisterns observed in all cases may have been responsible for this unusual condition, and it is therefore important to consider vasospasm as a probable etiological cause of clinical deterioration in patients undergoing the surgical removal of a cerebral tumor. For this reason, whenever any neurological deterioration occurs in such patients, it is advisable to perform TCD in order to verify the presence of any vasospasm and promptly commence suitable treatment.

Sommario

Il vasospasmo cerebrale è una condizione clinico-angiografica che si osserva frequentemente dopo una emorragia subaracnoidea da rottura di un aneurisma intracranico. L'osservazione del vasospasmo dopo l'exeresi di un tumore cerebrale è riportato in letteratura in 20 casi. Segnaliamo 5 nuovi casi di vasospasmo verificatisi dopo l'asportazione di un tumore cerebrale, trattandone gli aspetti patogenetici. A nostro avviso è importante considerare il vasospasmo come probabile causa eziologica di deterioramento clinico nei pazienti sottoposti ad intervento chirurgico di rimozione di un tumore cerebrale. Per tale motivo, nei pazienti operati per tumore cerebrale che presentino un deterioramento dello stato neurologico, è consigliabile l'esecuzione di un doppler transcranico, al fine di rilevare l'eventuale presenza di vasospasmo cerebrale ed instaurare prontamente la terapia adeguata.

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References

  1. Adams C.B.T.:Vasospasm: occurrence in conditions other than subarachnoid hemorrhage from a bleeding aneurysm. In: Wilkins R.H. (Ed.), Cerebral arterial spasm, Baltimore, Williams & Wilkins, 471, 1980.

    Google Scholar 

  2. Aoki N., Origitano T.C., Al-Mefty O.:Vasospasm after resection of skull base tumors. Acta Neurochir., 132: 53–58, 1995.

    Google Scholar 

  3. Brau R.H., Lameiro J., Llaguno A.V., Rifkinson N.:Metamorphopsia and permanent cortical blindness after a posterior fossa tumor. Neurosurgery, 19: 263–266, 1986.

    PubMed  Google Scholar 

  4. Boullin D.J., Tagari P., Du Boulay G. et al.:The role of hemoglobin in the etiology of cerebral vasospasm. An in vivo study of baboons. J. Neurosurg., 59: 231–236, 1983.

    PubMed  Google Scholar 

  5. Camp P.E., Paxton H.D., Buchan G.C., Gahbauer H.:Vasospasm after trans-sphenoidal hypophysectomy. Neurosurgery, 7: 382–386, 1980.

    PubMed  Google Scholar 

  6. de Almeida G.M., Bianco E., Souza A.S.:Vasospasm after acoustic neuroma removal. Surg. Neurol., 23: 38–40, 1985.

    PubMed  Google Scholar 

  7. Krayenbuhl H.:Beitrag zur Frage des cerebralen angiospastichen insultes. Schweiz Med Wochenschr., 90: 961–965, 1960.

    Google Scholar 

  8. LeRoux P.D., Haglund M.M., Mayberg M.R., Winn H.R.:Symptomatic cerebral vasospasm following tumor resection: report of two cases. Surg. Neurol., 36: 25–31, 1991.

    PubMed  Google Scholar 

  9. Martin N.A., Doberstein C., Zane C. et al.:Post-traumatic cerebral arterial spasm: transcranial doppler ultrasound, cerebral blood flow, and angiographic findings. J. Neurosurg., 77: 575–583, 1992.

    PubMed  Google Scholar 

  10. Mawk J.R., Ausman J.I., Erickson D.L., Maxwell R.E.:Vasospasm following transcranial removal of large pituitary adenomas: report of three cases. J. Neurosurg., 50: 229–232, 1979.

    PubMed  Google Scholar 

  11. Peerless S.J.:Postoperative cerebral vasospasm without subarachnoid hemorrhage. In: Wilkins R.H. (Ed.), Cerebral arterial spasm. Baltimore, Williams & Wilkins, 496–498, 1980.

    Google Scholar 

  12. Sekhar L.N., Wechsler L.R., Yonas H.R. et al.:Value of TCD examination in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage. Neurosurgery, 22: 813–821, 1988.

    PubMed  Google Scholar 

  13. Wilkins R.H.:Hypothalamic dysfunction and intracranial arterial spasm. Surg. Neurol., 4: 472–480, 1975.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Istituto Mediterraneo Neurologico “Neuromed”, IRCCS, Pozzilli (Is)

    Cervoni L. & Salvati M.

  2. Dipartimento di Scienze Neurologiche — 2a Cattedra di Neurochirurgia, Università “La Sapienza” di Roma, Italy

    Santoro A.

Authors
  1. Cervoni L.
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  2. Salvati M.
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  3. Santoro A.
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Cervoni, L., Salvati, M. & Santoro, A. Vasospasm following tumor removal: report of 5 cases. Ital J Neuro Sci 17, 291–294 (1996). https://doi.org/10.1007/BF01997789

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  • DOI: https://doi.org/10.1007/BF01997789

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