Symptomatic cerebral vasospasm following removal of acoustic neurinoma with non enhancement: A case report

Abstract

We report a case of symptomatic cerebral vasospasm following resection of the acoustic neurinoma. A 31-year-old woman had left hearing loss, a one-month history of headache and truncal ataxia. CT and MRI showed a non-enhanced mass at the left C-P angle and hydrocephalus. We performed subtotal tumor resection via lateral suboccipital approach. Unexpectedly, the tumor bled easily and hemostasis was difficult. Postoperative CT showed subarachnoid hemorrhage (SAH) in the basal cistern. The patient developed left facial nerve palsy postoperatively. On the 18th day postoperatively, the patient developed confusion, aphasia, and right hemiparesis. Cerebral angiography showed segmental spasm in the left C1, Al, M1 portion. We performed triple H therapy (hypervolemic, hemodilution, induced hypertension) for vasospasm. Cerebral vasospasm commonly occurs after aneurysmal SAH. A review of the literature disclosed only 32 cases including our case, that presented symptomatic vasospasm after tumor resection. These findings suggest that SAH in the basal cistern caused vasospasm.