Shida N, Nakasato N, Mizoi K, Kanaki M, Yoshimoto T
Department of Neurosurgery, Tohoku University School of Medicine, Sendai.
Neurol Med Chir (Tokyo). 1998 Oct;38(10):666-8. doi: 10.2176/nmc.38.666.
A 36-year-old female presented with cerebral infarction due to severe vessel stenosis after spontaneous rupture of a craniopharyngioma, manifesting as aphasia and drowsiness. Neuroimaging showed the suprasellar cystic tumor with wall enhancement and cerebral infarction in the left temporoparietal region, and also enhancement of the left sylvian fissure and prepontine cistern. Angiography showed severe narrowing at the C1 portion of the left internal carotid artery (ICA) and the M1 portion of the left middle cerebral artery (MCA). The tumor was subtotally removed via a bifrontal craniotomy. There was accumulated milky-white debris around the left ICA and MCA. She became alert within a few days postoperatively. Repeat angiography 1 month after surgery demonstrated slight improvement of vessel narrowing. The neuroimaging and intraoperative findings suggested that the stenosis was due to vasospasm induced by chemical meningitis resulting from cyst rupture.
一名36岁女性因颅咽管瘤自发破裂后严重血管狭窄导致脑梗死，表现为失语和嗜睡。神经影像学检查显示鞍上囊性肿瘤伴壁强化，左侧颞顶叶区域脑梗死，左侧外侧裂和脑桥前池也有强化。血管造影显示左侧颈内动脉（ICA）C1段和左侧大脑中动脉（MCA）M1段严重狭窄。通过双额开颅术将肿瘤次全切除。左侧ICA和MCA周围有乳白色碎屑积聚。术后几天她变得清醒。术后1个月重复血管造影显示血管狭窄略有改善。神经影像学和术中发现提示狭窄是由囊肿破裂引起的化学性脑膜炎诱发的血管痉挛所致。
