Effect of craniopharyngioma fluid on femoral vessels of rat

Abstract

Craniopharyngioma fluid spillage during surgery is reported to cause aseptic meningitis, but effects of the spillage on vessels have not yet been studied. Therefore we experimentally studied the effect of external contact on femoral vessels of the rat to assess its possible role in the cerebral vascular complications. The major direct effect of the craniopharyngioma fluid on the femoral vessels was vasospasm, appearing on the fourth day after instillation. The vasospasm was observed in 83% of femoral vessels studied between 4-15 days and one of the vessels showed intra-luminal thrombus. The difference in the vessel diameter after instillation (4-15 days) was compared with the controls and was statistically significant (p < 0.01). These findings correspond well with the observed deterioration on post-operative days 5-7, due to vascular complications. No histopathologic (light-microscopic) changes of inflammation or necrosis were found in the femoral vessels. Our study shows that contact of craniopharyngioma fluid to arteries leads to vasospasm, and spillage during surgical excision may contribute to vascular complications encountered in the post-operative period. Prevention of spillage of this fluid and the routine use of cerebral vasodilators to prevent ischemic complications after craniopharyngioma surgery needs further evaluation.

The learning curve in endoscopic endonasal resection of craniopharyngiomas

“…An experimental model with rat femoral arteries has demonstrated that direct contact of the vessel with craniopharyngioma cystic fluid induces arterial vasospasm. 13 Therefore, the craniopharyngioma cyst must be entered in a controlled fashion. A small opening is created in the cyst wall with simultaneous aspiration at the puncture site to avoid spillage of cyst contents into the subarachnoid space.…”

Pituitary necrosis and vasospasm following removal of craniopharyngioma

“…However, a delayed vasospasm induced by chemical effect of the cystic components cannot be entirely excluded [1,4].…”

“…Vasospasm following removal of craniopharyngioma has only been described in a few instances [2,3] and has been attributed to chemical effects of fluid from cystic craniopharyngioma [1,4]. Shida et al report a spontaneous rupture of a craniopharyngioma cyst that may have caused symptomatic vasospasm of major cranial vessels before surgical treatment or cranial irradiation.…”

“…Shida et al report a spontaneous rupture of a craniopharyngioma cyst that may have caused symptomatic vasospasm of major cranial vessels before surgical treatment or cranial irradiation. Vasospasm appeared in 83% of femoral vessels exposed to craniopharyngioma fluid after 4 days in an experiment done in rats [1].…”

“…Cerebral vascular complications following craniopharyngioma removal include cerebral infarction, thrombosis, fusiform aneurysm, and vasospasm [1].…”