ABSTRACT
Objective:To explore the clinical signiifcance of the protection of superior petrosal vein (SPV) in the microneurosurgery for acoustic neuroma. Methods:From January 2009 to July 2011, 149 cases of acoustic neuroma microsurgery were observed. hTe difference in hematoma in surgical area, cerebellar hematoma and cerebellar edema were compared between a SPV without protection group (SPVWP group, n=8) and a SPV protection group (SPVP group, n=141). Results:In the 149 patients with acoustic neuroma, the SPV was reserved in 141 patients. In the SPVWP group (8 patients), hematoma in the surgery area occurred in 4 patients, cerebellar edema in 5, and cerebellar hemorrhage in 3. In the SPVP group (141 patients), hematoma in the surgery area occurred in 40 patients, cerebellar edema in 56, and cerebellar hemorrhage in 12. hTere was signiifcant difference in the incidence of cerebellar hemorrhage (χ2=3.84, P=0.05), no signiifcant difference in the incidence of hematoma in the surgical area (χ2=0.646, respectively, P=0.422), and no significant difference in the incidence of cerebellar edema (χ2=0.611, P=0.434) between the SPVWP group and the SPVP group. Conclusion:In acoustic neuroma surgery, the SPV should be protected, which may reduce the risk of cerebellar hemorrhage.
ABSTRACT
The authors present a case of cerebrellar venous hemorrhagic infarction which developed after removal of a cerebellopontine angle meningioma. The clinical course was rapidly fatal inspite of an aggressive management including surgical decompression beginning from 30 minutes after complete recovery from anesthesia. The brain C-T scan showed flame-shaped subcortical hemorrhage which is known to be a typical finding of a venous hemorrhagic infarction. The causes may be two fold:One is the cautrization and resection of multiple petrosal veins which were inevitable because of a bleeding from the vein and the other is the venous congestion caused by the compression of an internal jugular vein in oblique supine position. Reminding of one or oth of the above possibilities whenever we are performing surgery around the superior petrosal vein may help us to prevent the rare but fatal complication of this kind.