Vasospasm after resection of skull base tumors.

Vasospasm after resection of skull base tumors is a rare complication that often produces serious ischemic sequelae. In four of the authors' recent cases, vasospasm complicated the patient's postoperative course. A review of the literature produced a number of cases that can help determine possible causes of vasospasm after tumor resection, ways to prevent it, and methods to evaluate it when it occurs. The cause appears to be multifactorial and the surgical approach may contribute to the pathogenesis of vasospasm. Physicians must have a high degree of suspicion to detect vasospasm at an early stage of skull base surgery. Cerebral blood flow measurement and transcranial Doppler are useful monitoring tools.