Subarachnoid hemorrhage and vasospasm following removal of craniopharyngioma.

A patient who had transcranial removal of a craniopharyngioma developed a large, postoperative subarachnoid hematoma in the basal cisterns. The patient developed cerebral vasospasm with infarction. A review of the literature found 20 cases of vasospasm associated with surgical removal of intracranial tumors. These cases were reviewed to determine the role of subarachnoid blood in the causation of vasospasm. In most cases, vasospasm is caused by subarachnoid blood. Multiple causes for arterial narrowing may be present, such as radiation vasculopathy, iatrogenic arterial injury and infection, and may be impossible to exclude as factors contributing to arterial narrowing.