Extracranial–intracranial bypass in medial sphenoid ridge meningioma associated with severe stenosis of the intracranial segments of the internal carotid artery
| Autor: | Zhong Wang, Yabo Huang, Qingdong Han |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Decompressive Craniectomy Tumor resection Constriction Pathologic 030204 cardiovascular system & hematology Neurosurgical Procedures Meningioma sphenoid ridge meningioma 03 medical and health sciences 0302 clinical medicine Extracranial intracranial bypass medicine.artery Sphenoid Bone medicine Meningeal Neoplasms Effective treatment Humans Carotid Stenosis Severe stenosis Clinical Case Report Cerebral Revascularization business.industry Angiography Digital Subtraction General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Ridge (meteorology) extracranial–intracranial bypass Female Radiology Internal carotid artery business internal carotid artery stenosis Tomography X-Ray Computed 030217 neurology & neurosurgery Carotid Artery Internal Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| Popis: | Rationale: Tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery (ICA) of intracranial segments has been rarely presented. Effective treatment as to the complex lesions may be complicated. Tumor resection and cerebrovascular protection should be both taken into consideration. Patient concerns: We presented one case of medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments. The patient suffered hyperthyroidism, mirror-image dextrocardia and congenital heart disease atrial septal defect simultaneously. Diagnoses: Before the neurosurgical treatment , the colleagues of department of cardiac surgery, anesthesiology and respiratory medicine agreed on our plan of resecting the tumor following the comprehensive evaluation of basal clinical conditions in the patient. For reducing the bleeding intraoperatively, the interventional branch performed digital subtraction angiography(DSA) and found collateral anastomosis between the supplying vessels of left middle meningeal arteries and anterior choroid arteries. No preoperative interventional embolization was determined considering the risk of cerebral ischemia. Interventions: The following subtotal resection of medial sphenoid ridge meningioma and left extracranial-intracranial bypass were carried out. Additionally, ipsilateral decompressive craniectomy was done. Post-operative imaging Computed tomography (CT), Computed tomography angiography (CTA) and Transcranial Doppler (TCD) indicated subtotal resection of tumor and bypass patency. Outcomes: The patient was discharged with the right limbs of muscle strength of grade IV. The muscle strength of the patient returned to grade V after 6 months of follow-up. Lessons: Comprehensive treatment of tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments is effective. |
| Databáze: | OpenAIRE |
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