Background: Sphenoid wing meningiomas present close contact with intracranial arteries and have great potential for vascular complications. Here, we describe the case of a patient who presented a medial left giant lesser sphenoid wing meningioma involving the supraclinoid carotid artery. One week after surgery, she developed vasospasm whose treatment using milrinone achieved excellent results. Case Description: This is the case of a 23-year-old female with a large meningioma of the middle third of the lesser wing of the left sphenoid. Furthermore, the patient had symptoms of headache, diplopia, and left amaurosis (Video 1). The lesion involved the supraclinoid left carotid artery, causing significant stenosis of the vessel. The patient underwent surgical treatment without complications. One week after the procedure, she evolved with lowered level of consciousness, complete, and proportionate right hemiparesis and right Babinski's sign. Angiographic study demonstrated significant stenosis of the left supraclinoid artery. After endovascular treatment with milrinone, the patient evolved with immediate improvement of signs and symptoms.Video 1:Surgical procedure. Video is accessible from the portal. Conclusion: Giant meningiomas with vascular involvement involve a higher risk of postoperative vascular complications. Other studies should be carried out to predict these complications and thus develop preventive measures. Copyright:
Background: Sphenoid wing meningiomas present close contact with intracranial arteries and have great potential for vascular complications. Here, we describe the case of a patient who presented a medial left giant lesser sphenoid wing meningioma involving the supraclinoid carotid artery. One week after surgery, she developed vasospasm whose treatment using milrinone achieved excellent results. Case Description: This is the case of a 23-year-old female with a large meningioma of the middle third of the lesser wing of the left sphenoid. Furthermore, the patient had symptoms of headache, diplopia, and left amaurosis (Video 1). The lesion involved the supraclinoid left carotid artery, causing significant stenosis of the vessel. The patient underwent surgical treatment without complications. One week after the procedure, she evolved with lowered level of consciousness, complete, and proportionate right hemiparesis and right Babinski's sign. Angiographic study demonstrated significant stenosis of the left supraclinoid artery. After endovascular treatment with milrinone, the patient evolved with immediate improvement of signs and symptoms.Video 1:Surgical procedure. Video is accessible from the portal. Conclusion: Giant meningiomas with vascular involvement involve a higher risk of postoperative vascular complications. Other studies should be carried out to predict these complications and thus develop preventive measures. Copyright:
0:13 – Clinical presentation0:39 – Neurological examination0:44 – Neuroimage findings2:05 – Rationale for procedure2:29 – Risks of the procedure and its potential benefits3:12 – Alternatives and why they were not chosen4:05 – Description of the setup4:25 – Necessary equipment4:36 – Key surgical steps4:42 – Video7:02 – Disease background8:12 – A brief review of clinical and image outcome.
Authors: Michael A Mooney; Walid Ibn Essayed; Mohammad Ali Aziz-Sultan; Ossama Al-Mefty Journal: Oper Neurosurg (Hagerstown) Date: 2021-07-15 Impact factor: 2.703
Authors: K Mariam Slot; Dagmar Verbaan; Lisette Bosscher; Esther Sanchez; W Peter Vandertop; Saskia M Peerdeman Journal: World Neurosurg Date: 2018-01-08 Impact factor: 2.104
Authors: D Jay McCracken; Raymond A Higginbotham; Jason H Boulter; Yuan Liu; John A Wells; Sameer H Halani; Amit M Saindane; Nelson M Oyesiku; Daniel L Barrow; Jeffrey J Olson Journal: Neurosurgery Date: 2017-06-01 Impact factor: 4.654
Authors: Priscilla K Brastianos; Evanthia Galanis; Nicholas Butowski; Jason W Chan; Ian F Dunn; Roland Goldbrunner; Christel Herold-Mende; Franziska M Ippen; Christian Mawrin; Michael W McDermott; Andrew Sloan; James Snyder; Ghazaleh Tabatabai; Marcos Tatagiba; Joerg C Tonn; Patrick Y Wen; Kenneth Aldape; Farshad Nassiri; Gelareh Zadeh; Michael D Jenkinson; David R Raleigh Journal: Neuro Oncol Date: 2019-01-14 Impact factor: 12.300