Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario, Canada.
J Neurointerv Surg. 2013 Sep 1;5(5):413-8. doi: 10.1136/neurintsurg-2012-010477. Epub 2012 Aug 21.
To perform a systematic review of the literature of cases of vasospasm following tumor resection and to discuss possible etiologies, diagnosis and management of this complication.
A literature search was performed using relevant search key words to identify cases of 'cerebral vasospasm' as a complication following tumor resection. Articles were identified by searching MEDLINE and PubMed databases. Relevant cross references were added by manually searching the references of all retrieved articles.
There were a total of 56 patients in our initial search but only 40 cases matched our inclusion criteria. Pituitary tumors and sellar area were the most common pathologies and location associated with this complication. Average time interval to development of symptomatic vasospasm was 8 days and mortality was high (30%). The most common encountered causative factors were vascular factors (vessel encasement, displacement and narrowing) and presence of blood in the basal cisterns in postoperative scans.
'Cerebral vasospasm' after tumor resection is a rare but challenging complication with very high morbidity and mortality in reported cases. Vasospasm following brain tumor surgery shares some of the same clinical variables (time interval, causative factors, morbidity and death rates) of vasospasm after aneurysmal subarachnoid hemorrhage. A high index of suspicion is required for early diagnosis and prompt management which are key elements of final outcome.
对肿瘤切除术后血管痉挛的病例进行系统综述，并讨论这种并发症的可能病因、诊断和处理方法。
使用相关的搜索关键词进行文献检索，以确定肿瘤切除术后并发“脑血管痉挛”的病例。通过搜索 MEDLINE 和 PubMed 数据库来识别文章。通过手动搜索所有检索到的文章的参考文献，添加了相关的交叉引用。
我们最初的搜索共找到了 56 例患者，但只有 40 例符合我们的纳入标准。垂体瘤和鞍区是最常见的与这种并发症相关的病理和部位。症状性血管痉挛的平均时间间隔为 8 天，死亡率很高（30%）。最常见的致病因素是血管因素（血管包裹、移位和狭窄）以及术后扫描基底池内有血液。
肿瘤切除术后的“脑血管痉挛”是一种罕见但具有挑战性的并发症，在已报道的病例中发病率和死亡率都很高。脑肿瘤手术后的血管痉挛与蛛网膜下腔出血后血管痉挛具有一些相同的临床变量（时间间隔、致病因素、发病率和死亡率）。早期诊断和及时处理需要高度怀疑，这是最终结果的关键因素。
