Vasospasm following tumor removal: report of 5 cases.

Cerebral vasospasm is a clinical/angiographical condition frequently observed after a subarachnoid hemorrhage due to the rupture of an intracranial aneurysm. Twenty cases of vasospasm observed after the removal of cerebral tumors have been reported in the literature; we here report on a further five. The time of onset of symptomatic vasospasm was 3-7 days after surgery; three of the patients died of an ischemic event induced by the vasospasm and two survive. Although no angiographic confirmation was obtained in our cases, serial transcranial Doppler (TCD) flow velocities were always high. It is suggested that the TCD-revealed accumulation of blood in the basal cisterns observed in all cases may have been responsible for this unusual condition, and it is therefore important to consider vasospasm as a probable etiological cause of clinical deterioration in patients undergoing the surgical removal of a cerebral tumor. For this reason, whenever any neurological deterioration occurs in such patients, it is advisable to perform TCD in order to verify the presence of any vasospasm and promptly commence suitable treatment.