Vasospasm after cranial base tumor resection: pathogenesis, diagnosis, and therapy

Bejjani, Ghassan K.; Sekhar, Laligam N.; Yost, Ann Marie; Bank, William O.; Wright, Donald C.

doi:10.1016/s0090-3019(99)00108-1

Cited by 96 publications

(84 citation statements)

References 15 publications

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“…11 Cerebral vasospasm may be seen after skull base surgeries which needs to be managed with triple-H therapy. 12 It has been also seen that intracranial tumour surgery may result in a post-operative fibrinogen deficiency leading to a poor outcomes and increased need for blood transfusions 13 In present study, we saw that the mean heart rate was higher and the mean blood pressure was lower in the transfused group than in the non-transfused group. Similarly, the patients in transfused group received more crystalloid infusion than those in non-transfused group.…”

Section: Discussionsupporting

confidence: 49%

A review of the blood transfusion practices in neuroanesthesia in the perioperative period in a tertiary care hospital

et al. 2017

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INTRODUCTIONThe World Health Organization identifies anemia as hemoglobin thresholds of 11.0 g/dl for children between 0.50-4.99 year, 11.5 g/dl for children 5.0-11.99 year, 12.0 g/dl for children 12.0-14.99 year, and nonpregnant women ≥15.0 year, 11.0 g/dl for pregnant women and 13.0 g/dl for men ≥15.0 year.1 Blood transfusion refers to the perioperative administration of blood and blood components (e.g. autologous blood, allogeneic whole blood, red blood cells, fresh frozen plasma [FFP], platelets, and cryoprecipitate). ABSTRACTBackground: Blood transfusion involves the administration of blood and blood components. Neurosurgical procedures are associated with significant blood loss with the need for blood transfusion in the preoperative, intraoperative and postoperative period to maintain optimal hemodynamic and cerebral oxygenation. Various neurosurgical procedures as traumatic brain injury, complex spinal surgeries, and endovascular neurosurgical procedures may need blood transfusions to maintain the optimal physiology. Methods: This study was performed prospectively at a tertiary care hospital in northern India with about a work load of 800 to 1000 elective neurosurgical surgical procedures being done per year. This data was collected prospectively over a period of one year from the patients being operated for elective neurosurgical procedures and later on shifted to the neurosurgical intensive care unit and the neurosurgical wards. The patients operated for emergency procedures for traumatic brain surgery were not included in the study. Results: A total of 455 elective neurosurgical procedures were done during the study period. Out of these 455 patients there were 95 patients who were in the paediatric age group with age less than 12 years. Out of 360 adult patients 85 patients were in need of blood transfusion which constituted 23.6 percent of the operated patients. Out of these 85 patients 45 patients needed two transfusions in the form of whole blood or packed cells, 40 patients needed a single transfusion.42 units of fresh frozen plasma were transfused to 17 patients with 15 patients receiving platelet transfusions. Conclusions:In conclusion, neurosurgical population is associated with significant blood loss and a requirement of blood transfusion. About 47 percent of paediatric population needed blood transfusion in our study with around 24 percent of adult population. The transfusion requirement was mainly seen in patients with craniostenosis, meningiomas, cerebello pontine tumours and meningiomas.

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Section: Discussionsupporting

confidence: 49%

A review of the blood transfusion practices in neuroanesthesia in the perioperative period in a tertiary care hospital

et al. 2017

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“…Although less common, symptomatic vasospasm following intracranial tumour excision has been demonstrated in several small case series [2][3][4][5]. The underlying incidence of vasospasm in total is probably higher, but imaging of intracranial vessels is rarely performed in this patient group because the majority of patients are asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…The underlying incidence of vasospasm in total is probably higher, but imaging of intracranial vessels is rarely performed in this patient group because the majority of patients are asymptomatic. Vasospasm occurs most commonly at 7-14 days following surgery [2,3], but has been reported up to one month after surgical intervention [2].…”

Section: Discussionmentioning

confidence: 99%

“…Several mechanisms have been postulated in the pathogenesis of vasospasm following tumour excision [2][3][4][5]: N 1. Accumulation of blood breakdown products in the basal cisterns N 2.…”

Section: Discussionmentioning

confidence: 99%

“…Although vasospasm due to tumour removal has been treated successfully with hypervolaemic, hypertensive therapy [2,4,5], it appears not to be as beneficial when used in cases of vasospasm following dermoid cyst removal [1]. Intraarterial papaverine infusion and balloon angioplasty have been used in resistant cases with some success [2].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Intracranial vasospasm with delayed ischaemic deficit following epidermoid cyst resection

Aldwaik²,

Taylor³

et al. 2010

BJR

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ABSTRACT. Intracranial vasospasm following surgical removal of intracranial tumours is rare. To our knowledge there have been no previously reported cases of delayed vasospasm occurring post debulking of epidermoid cysts. We report a case in which vasospasm led to established cerebral infarction 2 weeks postoperatively. MRI and serial magnetic resonance angiography (MRA) reliably show initial multiple stenoses in the vertebral and internal carotid arteries followed by their spontaneous normalisation. MRA imaging is now of sufficient quality to enable it to be a safe and effective means of both looking for vasospasm and monitoring its resolution.

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Postsurgical Craniospinal Emergencies

Popolizio¹,

Ceddia²,

D’Angelo³

et al. 2006

Emergency Neuroradiology

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Vasospasm after cranial base tumor resection: pathogenesis, diagnosis, and therapy

Cited by 96 publications

References 15 publications

A review of the blood transfusion practices in neuroanesthesia in the perioperative period in a tertiary care hospital

A review of the blood transfusion practices in neuroanesthesia in the perioperative period in a tertiary care hospital

Intracranial vasospasm with delayed ischaemic deficit following epidermoid cyst resection

Postsurgical Craniospinal Emergencies

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