Massive Middle Cerebral Artery Infarction After Surgically Assisted Rapid Palatal Expansion: A Case Report

Dentofacial deformities have a marked impact on a patient's quality of life. Fortunately, these deformities often can be corrected through orthodontic and surgical treatment. In adults, transverse maxillary discrepancies are often corrected by performing a surgically assisted rapid palatal expansion (SARPE) procedure. This procedure is accompanied by many of the same complications involved in performing a Le Fort I osteotomy. Although major complications from maxillary surgery are uncommon, severe hemorrhage and cerebrovascular accidents are real risks accompanied by serious sequelae. The purpose of this case report is to describe a case in which a patient developed a massive middle cerebral artery infarct after a SARPE procedure. The authors discuss the possible etiology and pathogenesis of the complication. They also aim to remind surgeons of this rare complication to ensure prompt recognition and management to prevent delays in care.