Chronic Phase Intracranial Hemorrhage Caused by Ruptured Pseudoaneurysm Induced by Carmustine Wafer Implantation for Insulo-opercular Anaplastic Astrocytoma: A Case Report

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...

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Bibliographic Details
Published in:Neurologia medico-chirurgica 2015, Vol.55(11), pp.848-851
Main Authors: SATO, Kimitoshi, DAN, Mitsuru, YAMAMOTO, Daisuke, MIYAJIMA, Yoshiteru, HARA, Atsuko, KUMABE, Toshihiro
Format: Article
Language:English
Subjects:
biodegradable 1,3-bis(2-chloroethyl)-1-nitrosourea wafers
carmustine wafers
Case Report
Gliadel
intracranial hemorrhage
pseudoaneurysm
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Summary: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.
ISSN:0470-8105
1349-8029
DOI:10.2176/nmc.cr.2015-0186