Delayed Bilateral Symptomatic Vasospasm after Resection of a Skull Base Meningioma: Report on a New Case and Literature Review

• Main Authors: Matteo Capozza, Giovanni Barbagli, Andrea Boschi, Bahman Ashraf-Noubari, Sergio Nappini, Nicola Limbucci, Arturo Consoli, Leonardo Lenieri, Andrea Rosi, Salvatore Mangiafico
• Format: Article
• Language: English
• Published: Guilan University of Medical Sciences 2016-06-01
• Series: Iranian Journal of Neurosurgery
• Subjects: Cerebral Vasospasm; Tumor Resection; Tuberculum Sellae; Diaphragma Sellae; Nimodipine; Meningioma
• Online Access: http://irjns.org/browse.php?a_code=A-10-32-2&slc_lang=en&sid=1

Background and Importance: Symptomatic vasospasm is a well-known pathology associated with ruptured aneurysms. Nevertheless, this condition is rarely found as a result of skull base tumor removal. Case Presentation: We reported a new case of 40-year-old woman previously treated for a tuberculum and diaphragma sellae meningioma showing symptomatic vasospasm after twelve post-operative days without previously documented sub-arachnoid hemorrhage (SAH). A digital subtraction angiography (DSA) was performed, and a bilateral vasospasm was detected. After subsequent endovascular treatments by intra-arterial infusion of nimodipine, the patient experienced a full recovery. Conclusion: Symptomatic vasospasm after meningioma removal is a challenging and life-threatening condition. Early diagnosis is the key for successful treatment.