山梨医科大学雑誌　第3巻4号　147-153(1988)

Surgical Considerations of Cerebral Infarctions after Brain
Tumor Removal in Five Patients with Poor Outcome

Akira FUKAMACHI, Hidehito KOIZUMI, Hideaki NUKUI,
and Hideo KUNIMINE

Abstract: We encountered five patients whose operative outcomes were poor because of cerebral infarctions after brain tumor surgery. Their causative mechanisms were analyzed. In two patients with sphenoid ridge meningioma, the internal carotid artery (ICA) and middle cerebral artery (MCA) were injured during gutting the tumors with a loop electrode and a YAG laser. The arteries were occluded with clips. In one patient with craniopharyngioma, the origin of the MCA was torn after retraction of the frontal lobe and the ICA was also torn during a hemostatic maneuver. The rents were sutured but these vessels were eventually occluded. In another patient with craniopharyngioma, the root of a branch of the ICA was damaged by traction of the tumor and a Heifetz's encircling clip was applied for hemostasis. Howder the ICA was occluded postoperatively because of a distortion in the clip. In a patient with dermoid tumor in the Sylvian fissure, several small arteries buried in the tumor capsule around the bifurcation of the ICA were coagulated and then cut off. Postoperative computed tomography demonstrated that these small vessels had been the perforating arteries to the basal ganglia and internal capsule.

Key words: Postoperative complications, Cerebral infarctions, Arterial injuries




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