Successful treatment of suprasellar tumors associated with poor brain blood perfusion by severe intracranial arterial stenosis: two case reports

BMC Research Notes

Teiji Tominaga¹  Yoshikazu Ogawa² 

[1] Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan;Department of Neurosurgery, Kohnan Hospital, 4-20-1, Nagamachiminami, Taihaku-ku, Sendai, Miyagi 982-8523, Japan

关键词: Vascular reconstruction;    Skull base tumor;    Severe internal carotid artery stenosis;    Extended transsphenoidal approach;    Asymptomatic;   

Others  :  1140632
DOI  :  10.1186/1756-0500-6-499

 received in 2013-06-25, accepted in 2013-11-27,  发布年份 2013

【 摘 要 】

Background

Treatment strategy to prevent perioperative cerebral infarction in patients with asymptomatic severe stenosis of the internal carotid artery is not fully established.

Case presentation

Two patients were treated for skull base tumor in the presence of severe stenosis of the internal carotid artery, unilateral in one patient and bilateral in the other patient. Both patients were asymptomatic but had reduced vascular reserve capacity. The extended transsphenoidal approach was planned avoiding the low perfusion pressure region, with only conventional methods of maintaining blood pressure and PaCO₂ rather than performing prophylactic vascular reconstruction surgery, and successful tumor removals were achieved without causing further neurological or radiological deficits.

Conclusion

If the surgical route is planned to avoid the distribution of stenotic vessels and low perfusion pressure, prophylactic vascular reconstruction surgery would be unnecessary. Although more experiences based on sub-classified etiology for internal carotid artery stenosis are required, various types of operations including intracranial-extracranial vascular surgery might be justified based on this principle.

【 授权许可】

   
2013 Ogawa and Tominaga; licensee BioMed Central Ltd.

【 图 表 】

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