期刊
NEUROLOGIA MEDICO-CHIRURGICA
卷 55, 期 11, 页码 848-851出版社
JAPAN NEUROSURGICAL SOC
DOI: 10.2176/nmc.cr.2015-0186
关键词
biodegradable 1,3-bis(2-chloroethyl)-1-nitrosourea wafers; carmustine wafers; Gliadel (R); pseudoaneurysm; intracranial hemorrhage
Carmustine wafers improve the survival of patients with high-grade gliomas, but several adverse events have been reported. A 42-year-old man with left insulo-opercular anaplastic astrocytoma developed a massive intra-cavital hematoma with subarachnoid hemorrhage caused by ruptured pseudoaneurysm of the left middle cerebral artery (MCA) adjacent to the site of carmustine wafers implanted 6 months previously. Intraoperative finding demonstrated a dissection of the insular portion of the MCA, and pathological examination identified the resected pseudoaneurysm. This case demonstrates that carmustine wafers can cause changes in local vessels. Therefore, implantation of carmustine wafers near to important vessels passing close to the resection cavity should be considered with great caution.
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