Vascular complications in surgery for large and giant vestibular schwannomas
Abstract
Vascular complications are the main causes of mortality in vestibular schwannoma surgery.
PURPOSE OF THE STUDY: to analyze vascular complications in surgical treatment of large and giant vestibular schwannomas.
MATERIAL AND METHODS: over the past 10 years, 76 patients with large or giant vestibular schwannomas have been operated in the Neurosurgery Department of the Krasnoyarsk Regional Clinical hospital. Results.
RESULTS. Vascular complications were diagnosed in 19.7 % patients. Of these, hemorrhagic was observed in 3 (3.9 %), and ischemic in 12 (15.7 %) cases. hemorrhages were represented by two hematomas of the tumor bed and one case of pontine hemorrhage. Among ischemic complications, there were 2 cases of pontine ischemia and 10 varying cases of the cerebellum ischemia. Postoperative mortality in the group of large and giant tumors was 6.5 %.
CONCLUSION. Risk factors of vascular complications for patients with large and giant vestibular schwannomas are elderly age, brainstem pia mater lesion of the tumor and encasement of blood vessels. The basis of prophylaxis is an accurate assessment of the blood supply to tumor, condition of the blood vessels, intraoperative neurophysiological and postoperative clinical monitoring, as well as accurate and thorough dissection of the tumor capsule. In case of clinical manifestations of postoperative vascular complications, decompressive craniotomy of the posterior fossa is indicated, removal of the hematoma and, if necessary, the implantattion of external ventricular drainage.
About the Author
P. G. Rudenko
KGBUZ “Krasnoyarsk Regional Clinical Hospital”; Krasnoyarsk State Medical University named after prof. V. F. Voyno-Yasenetsky
Russian Federation
Russian Federation
Rudenko Pavel Gennadievich
Krasnoyarsk
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Review
For citations:
Rudenko P.G. Vascular complications in surgery for large and giant vestibular schwannomas. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(2):133-138. (In Russ.)
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