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Acta Neurochirurgica
Published in: Acta Neurochirurgica 3/2019

01-03-2019 | Nimodipine | Case Report - Vascular Neurosurgery - Ischemia

Intracranial stenting after tumor exeresis complicated by delayed kinking of the middle cerebral artery

Authors: Davide Simonato, Joseph Domenico Gabrieli, Giacomo Cester, Alessandro Della Puppa, Francesco Causin

Published in: Acta Neurochirurgica | Issue 3/2019

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Abstract

During intracranial tumor resection, the delayed kinking of a major encased vessel has never been described in literature. We present a case which required urgent endovascular treatment performed through a stent positioning. A patient was hospitalized with symptomatic sphenoid meningioma in the left middle cranial fossa. Twelve days after surgery, right-sided hemiplegia and aphasia occurred. Digital subtraction arteriography revealed a kinking of the M1 segment of the left middle cerebral artery and diffuse vasospasm. At first, intra-arterial nimodipine has been administered, obtaining the remission of the vasospasm. Secondly, a stent was positioned to treat the kinking, achieving a complete flow restoration.
Literature
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Alotaibi NM, Lanzino G (2013) Cerebral vasospasm following tumor resection. J Neurointerv Surg 5(5):413–418CrossRefPubMed
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Aoki N, Origitano TC, al-Mefty O (1995) Vasospasm after resection of skull base tumors. Acta Neurochir 132(1–3):53–58CrossRefPubMed
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Bejjani GK, Sekhar LN, Yost AM, Bank WO, Wright DC (1999) Vasospasm after cranial base tumor resection: pathogenesis, diagnosis, and therapy. Surg Neurol 52(6):577–583 discussion 583CrossRefPubMed
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McCracken DJ, Higginbotham RA, Boulter JH, Liu Y, Wells JA, Halani SH et al (2017) Degree of vascular encasement in sphenoid wing meningiomas predicts postoperative ischemic complications. Neurosurgery 80(6):957–966CrossRefPubMed
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Motoyama Y, Tanaka Y, Gurung P, Nakagawa I, Park Y-S, Nakase H (2016) A simple bracing technique to correct kinking of arterial branches to avoid ischemic sequelae during neurovascular surgery. Surg Neurol Int 7:8CrossRefPubMedPubMedCentral
Metadata
Title
Intracranial stenting after tumor exeresis complicated by delayed kinking of the middle cerebral artery
Authors
Davide Simonato
Joseph Domenico Gabrieli
Giacomo Cester
Alessandro Della Puppa
Francesco Causin
Publication date
01-03-2019
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 3/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-019-03822-7

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