Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Delayed Cerebral Infarction after Resection of Craniopharyngioma

두개인두종의 적출후 발현된 지연성 뇌경색

  • Park, Geun Chul (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Jung, Jin-Myung (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Joon Soo (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Jae Hyung (Department of Radiology, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Lee, Hyun Seok (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Hwang, Soo Hyun (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Park, In Sung (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Kim, Eun-Sang (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience) ;
  • Han, Jong Woo (Department of Neurosurgery, Gyeongsang National University College of Medicine and Gyeongsang Institute for Neuroscience)
  • 박균철 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 정진명 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김준수 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김재형 (경상대학교 의과대학 방사선과학교실, 신경과학연구소) ;
  • 이현석 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 황수현 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 박인성 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 김은상 (경상대학교 의과대학 신경외과학교실, 신경과학연구소) ;
  • 한종우 (경상대학교 의과대학 신경외과학교실, 신경과학연구소)
  • Received : 1999.12.13
  • Accepted : 2001.05.04
  • Published : 2001.07.28
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Abstract

Delayed cerebral infarction after resection of craniopharyngioma is a uncommon entity, but leads to high morbidity and mortality. We present 3 such cases and discuss the etiology and pathogenesis with review of pertinent literatures. In our cases, delayed deterioration of consciousness was observed in all cases. All of them expired. The cause may be multifactorial and the surgical approach may contribute to the pathogenesis of delayed cerebral infarction. We suspect vasospasm might be the major mechanism of pathogenesis. Vessels were primed to spasm during operation due to blood in the cistern or mechanical injury. Vasoactive materials may have been liberated from the pituitary stalk or injured hypothalamus, either at the time of surgery, or later, after portions of tumor have undergone necrosis. The high degree of suspicion to detect vasospasm should be done in the case of the delayed deterioration of mental status at an early stage of craniopharyngioma surgery. Possible mechanism underlying this delayed cerebral infarction are discussed.

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