Postembolization infarction in juvenile nasopharyngeal angiofibroma

Area of Science:

• Neurology
• Vascular Surgery
• Otolaryngology

Background:

• Juvenile nasopharyngeal angiofibroma (JNA) is a rare, benign tumor typically affecting adolescent males.
• Selective embolization of the internal maxillary artery (IMA) is a common preoperative adjunctive treatment for JNA to reduce vascularity.
• Cerebrovascular complications following embolization, though rare, are a significant concern.

Observation:

• An 18-year-old male with recurrent JNA underwent selective trans-femoral embolization of the IMA.
• Post-procedure, the patient exhibited symptoms of cerebro-vascular accident, including right-sided weakness, slurred speech, and drowsiness.
• A CT scan confirmed a diagnosis of postembolization infarction.

Findings:

• The patient experienced an ischemic stroke secondary to the embolization procedure.
• Despite the neurological event, the patient demonstrated a remarkable recovery with no residual clinical deficits.
• The infarction was attributed to unintended embolization or hemodynamic changes during the procedure.

Implications:

• This case highlights a rare but serious complication of IMA embolization in JNA management.
• It underscores the importance of meticulous technique and careful patient selection during embolization procedures.
• Further research into preventative strategies and management protocols for post-embolization stroke in this context is warranted.