Distant Wounded Glioma Syndrome: Report of Two Cases
| Autor: | Christopher J. Koebbe, Jonathan D. Sherman, Ronald E. Warnick |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Neoplasm Residual Postoperative Hemorrhage Cerebral Ventricles Lesion Central nervous system disease Vascularity Fatal Outcome Postoperative Complications Glioma medicine Coagulopathy Humans Cerebral Hemorrhage Vascular disease business.industry Brain Neoplasms Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Neurology (clinical) medicine.symptom Multifocal Glioblastomas Complication business Glioblastoma Tomography X-Ray Computed |
| Zdroj: | Neurosurgery. 48:940-944 |
| ISSN: | 0148-396X |
| DOI: | 10.1227/00006123-200104000-00053 |
| Popis: | Objective and importance We describe two cases of distant wounded glioma syndrome complicating surgical resection of multifocal glioblastoma multiforme. This clinical entity was previously described as a local phenomenon resulting in postoperative hemorrhaging within the cavity of partially resected tumors. These cases are unique, in that the postoperative hemorrhaging occurred within distant tumor nodules after gross total resection of the primary lesion. Clinical presentation and intervention Two middle-aged men without known risk factors for postoperative hemorrhaging presented with multifocal glioblastoma multiforme. Each underwent surgical resection of the deficit-producing lesion and developed hemorrhage at distant tumor sites that were not directly manipulated during the surgical procedures. The distant hemorrhage caused new neurological deficits, with severe morbidity. Conclusion We postulate that distant wounded glioma syndrome is a distinct clinical entity that causes remote postoperative hemorrhaging and that tumor-induced coagulopathy triggered by surgery seems to create a hypocoagulable state that is most concentrated within brain tissue. Because of their rich vascularity, these distant tumor nodules are more susceptible to hemorrhage, resulting from coagulation changes after tumor resection, than are other sites. They also exhibit increased blood flow after resection of a large mass, because of autoregulatory dysfunction induced by peritumoral edema, increasing the likelihood of hemorrhage at these sites. |
| Databáze: | OpenAIRE |
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