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Subarachnoid hemorrhage after preoperative embolization of a cystic meningioma
Authors:T Hayashi  K Shojima  H Utsunomiya  K Moritaka  E Honda
Affiliation:1. Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia;2. Anaesthesiology Unit, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia;1. Nutritional Support Unit, University Hospital Vall d''Hebron, Barcelona, Spain;2. Nutrition Unit, University Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain;3. Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;4. Fondazione Grigioni per il Morbo di Parkinson, Milano, Italy;5. Nutrition Unit, ALS Centre, University Hospital of Limoges, Limoges, France;6. Department of Neurology, University Hospital Münster, Germany;7. Clinical Nutrition, Geneva University Hospitals, Geneva, Switzerland;8. Cereneo (Center for Neurology and Rehabilitation) and University Department of Internal Medicine, Kantonsspital Aarau, Switzerland;9. Department of Geriatrics, Alexianer Hospital Krefeld, Krefeld, Germany;10. Department of Clinical Medicine, Sapienza, University of Rome, Rome, Italy;11. Department of Nutrition, Laikon General Hospital, Athens, Greece;12. Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium;13. Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands;14. Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Germany;15. Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Tel Aviv University, Petah Tikva, Israel;p. Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany;1. Division of Neurosurgery, John A. Burns School of Medicine, University of Hawai''i, Honolulu, Hawai''i, USA;2. Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA;3. Department of Neurosurgery, University of Texas Medical Branch, Galveston, Texas, USA;4. Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA;1. School of Veterinary Medicine, Azabu University, 1–17–71 Fuchinobe, Chuou-ku, Sagamihara, Kanagawa 252-5201, Japan;2. Center for Human and Animal Symbiosis Science, Azabu University, Kanagawa 252-5201, Japan;3. Division of Brain and Neurophysiology, Department of Physiology, Jichi Medical University, Tochigi 329-0498, Japan;4. DVMs Animal Medical Center Yokohama, 2-2 Sawatari, Kanagawa-ku, Yokohama, Kanagawa 221-0844, Japan;5. Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan;1. Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi''an, China;2. Department of Health Statistics, Fourth Military Medical University, Xi''an, China;3. Department of Neurology, The PLA 940 Hospital, Lanzhou, China;4. Department of Neurology, Xi''an No.3 Hospital, Xi''an, China;5. Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi''an, China;6. Department of Neurology, The First Affiliated Hospital of Xi''an Medical University, Xi''an, China;7. Department of Neurology, The First People''s Hospital of Xianyang, Xianyang, China;8. Department of Neurology, Xi''an Gaoxing Hospital, Xi''an, China;9. Department of Neurology, Yulin No 1 Hospital, Yulin, China;10. Department of Neurology, General Hospital of Xinjiang Military Command, Urumqi, China;11. Department of Neurology, Tongchuan People''s Hospital, Tongchuan, China;12. Department of Neurology, Tongchuan Mining Bureau Hospital, Tongchuan, China;13. Department of Neurology, Xi''an Central Hospital, Xi''an, China;14. Department of Neurology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China;15. Department of Neurology, Gansu Provincial Central Hospital, Lanzhou, China;p. The Shaanxi Cerebrovascular Disease Clinical Research Centre, Xi''an, China;1. John A. Burns School of Medicine, Honolulu, Hawaii, USA;2. Department of Neurosurgery, Emory University, Atlanta, Georgia, USA;3. Atlanta VA Health Care System, Decatur, Georgia, USA
Abstract:We present a case of cystic meningioma accompanied by hemorrhage in the cyst and adjacent subarachnoid space that occurred while preoperative embolization in feeders of the tumor was being applied. The possible reason for the hemorrhage was the sudden dynamic changes in blood flow triggered by the embolization. The changes could have caused multiple ruptures of pathologic small vessels. We recommend that preoperative embolization should be used cautiously in treating cystic meningiomas because of a possible increase in bleeding from pathologic weak vessels.
Keywords:
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