A Complicated Case of An Intracranial Epidermoid Cyst

Intracranial vasospasm and ischaemic cerebrovascular accident (CVA) following surgical removal of intracranial tumours are rare. To our knowledge, vasospasm has been reported in only two cases following surgery, with one occurring two weeks post-surgery and the other after four days. However, ischaemic CVA following surgery has not been previously reported. We present a case in which vasospasm resulted in cerebral infarction immediately postoperatively. MRI and serial magnetic resonance angiography (MRA) revealed no flow in the internal carotid artery and middle cerebral artery, with ultrasound showing multiple thrombi in the internal carotid artery and stenotic features in the left middle cerebral artery.

Intracranial vasospasm and ischaemic cerebrovascular accident (CVA) following surgical removal of intracranial tumours are rare.We report a case of ischaemic CVA and vasospasm following resection of an intracranial epidermoid cyst. Although the tumour was completely resected, vasospasm and ischaemic injury led to significant neurological deficits.Perioperative corticosteroids may be beneficial in reducing the incidence of vasospasm and ischaemic events, though their efficacy can vary.