Symptomatic Cerebral Vasospasm Following the Resection of Petroclival Meningioma

Petroclival meningioma (PCM) represents a formidable challenge due to its intimate association with the brainstem, basilar artery, perforating arteries, and cranial nerves. Vasospasm is a recognized complication in neurosurgery. Its incidence following skull base surgery is unknown. Here, we present a 33-year-old woman who was diagnosed with PCM and managed surgically with the anterior transpetrosal approach. Two days postoperatively, she developed sudden confusion, blurred vision, and right-sided weakness. Cerebrovascular imaging confirmed the diagnosis of vasospasm. The patient was managed successfully with combined medical and endovascular treatment of vasospasm which resulted in significant clinical improvement. Vasospasm following skull base surgery is rare. Early recognition of such rare complication and prompt response are key to achieving excellent clinical outcomes.