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The role of metabolism in the ischemia associated with vasospasm following brain tumor resection
  1. Marcelo de Lima Oliveira,
  2. Milena Krajnyk de Azevedo,
  3. Michel Ferreira Machado,
  4. Manoel Jacobsen Teixeira,
  5. Edson Bor-Seng-Shu
  1. Division of Neurological Surgery, Hospital das Clinicas of S⭠Paulo University Medical School, São Paulo, Brazil
  1. Correspondence to Dr Edson Bor-Seng-Shu, Division of Neurological Surgery, Hospital das Clinicas of São Paulo University Medical School, São Paulo, Brazil; edsonshu{at}gmail.com

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Alotaibi et al have reviewed cerebral vasospasm following resection of intracranial tumor. Vasospasm is unusual after intracranial tumor resections and is associated with high morbidity and mortality. In general, the pathogenesis of cerebral ischemia related to vasospasm is complex and may be linked to an uncoupling of cerebral blood flow and metabolism.1 4

We present the case of a 52-year-old woman with a 4-year history of periods of disorientation and cognitive deficits. A left sphenoid wing meningioma (figure 1) was diagnosed, and a Simpson III surgical resection was performed. On the first postoperative day, the patient developed reduced consciousness and motor deficits on the right side. CT was compatible with ischemia and swelling on left cerebral hemisphere associated with midline shift. The patient underwent a decompressive craniectomy to relieve the intracranial hypertension. On the same day, transcranial …

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