Produção Nacional
Revisado por pares
Symptomatic Cerebral Vasospasm and Delayed Cerebral Ischemia Following Transsphenoidal Resection of a Craniopharyngioma
2015; Elsevier BV; Volume: 24; Issue: 9 Linguagem: Inglês
10.1016/j.jstrokecerebrovasdis.2015.06.005
ISSN1532-8511
AutoresIrapuá Ferreira Ricarte, Bruno Ferreira Funchal, Maramélia Miranda, Daniela Laranja Gomes, Raul Alberto Valiente, Flávio A. Carvalho, Gisele Sampaio Silva,
Tópico(s)Meningioma and schwannoma management
ResumoVasospasm has been rarely described as a complication associated with craniopharyngioma surgery. Herein we describe a patient who developed symptomatic vasospasm and delayed cerebral ischemia after transsphenoidal surgery for a craniopharyngioma.A 67-year-old woman became drowsy 2 weeks after a transsphenoidal resection of a craniopharyngioma. A head computed tomography (CT) was unremarkable except for postoperative findings. Electroencephalogram and laboratory studies were within the normal limits. A repeated CT scan 48 hours after the initial symptoms showed bilateral infarcts in the territory of the anterior cerebral arteries (ACA). Transcranial Doppler (TCD) showed increased blood flow velocities in both anterior cerebral arteries (169 cm/second in the left ACA and 145 cm/second in the right ACA) and right middle cerebral artery (164 cm/second) compatible with vasospasm. A CT angiography confirmed the findings. She was treated with induced hypertension and her level of consciousness improved. TCD velocities normalized after 2 weeks.Cerebral vasospasm should be considered in the differential diagnosis of patients with altered neurologic status in the postoperative period following a craniopharyngioma resection.
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