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Vasospasm after acoustic neuroma removal
Surgical Neurology
|January 1, 1985
Summary
Acoustic neuroma surgery can lead to delayed complications. Blood in the basal cisterns may cause vasospasm and brain ischemia, a rare but serious outcome.
Area of Science:
- Neurosurgery
- Neurology
- Neuroradiology
Background:
- Acoustic neuromas require surgical intervention, often with potential complications.
- Two-stage removal was performed due to severe intraoperative bleeding.
Observation:
- Patient developed progressive right hemiplegia and aphasia on the 8th postoperative day.
- Cerebrospinal fluid analysis revealed blood.
- Angiography demonstrated vasospasm, and CT scan showed an ischemic area.
Findings:
- Subarachnoid hemorrhage in the basal cisterns was identified as the likely cause of delayed neurological deficits.
- The presence of blood induced vasospasm and subsequent brain ischemia.
- This represents a rare complication, with only one similar case previously reported in the literature.
Implications:
- Highlights the potential for delayed ischemic complications following acoustic neuroma surgery, particularly after significant bleeding.
- Emphasizes the importance of neuroradiological evaluation for vasospasm and ischemia in patients with unexplained neurological deterioration post-surgery.
- Suggests that managing or preventing subarachnoid hemorrhage in the basal cisterns may be crucial in mitigating these risks.