CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2024; 13(02): 147-149
DOI: 10.1055/s-0042-1742477
Case Report

Post-operative Corona Radiata Infarct in a High-flow EC-IC Bypass: Report of Unusual Complication

1   Department of Neurosurgery, National Institute of Neurosciences and Hospital, Shere-e-bangla Nagar, Dhaka, Bangladesh
,
Mohammod Raziul Haque
2   Department of Neurosurgery, Dhaka Medical College and Hospital, Dhaka, Bangladesh
› Institutsangaben

Abstract

Long insular artery (LIA) infarct can occur after insular glioma surgery. LIA infarct after extracranial-intracranial (EC-IC) bypass is very rare, and so far, it is not reported in EC-IC bypass. Here, we report a case of high-flow EC-IC bypass, where postoperatively, the patient developed isolated LIA infarct. A 65-year-old female presented with recurrent severe headache along with altered sensorium. Computed tomography (CT) scan and CT angiography (CTA) of the brain showed ruptured large left internal carotid artery (ICA) fusiform aneurysm. She underwent left-sided, high-flow EC-IC bypass involving upper trunk of left middle cerebral artery (MCA) and ICA ligation at neck at its origin. Postoperatively, the patient developed right sided hemiplegia. Postoperative MRI of the brain showed left-sided external capsular infarct, extending up to the corona radiata resulted from LIA infarct. By the end of 6 months after operation, she could walk with support but her left upper limb remained more severely affected and magnetic resonance angiogram (MRA) showed almost disappearance of aneurysm with functioning bypass.



Publikationsverlauf

Artikel online veröffentlicht:
28. Mai 2022

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  • References

  • 1 Tamura A, Kasai T, Akazawa K. et al. Long insular artery infarction: characteristics of a previously unrecognized entity. AJNR Am J Neuroradiol 2014; 35 (03) 466-471
  • 2 Lee PH, Oh SH, Bang OY, Joo IS, Huh K. Pathogenesis of deep white matter medullary infarcts: a diffusion weighted magnetic resonance imaging study. J Neurol Neurosurg Psychiatry 2005; 76 (12) 1659-1663
  • 3 Yonemura K, Kimura K, Minematsu K, Uchino M, Yamaguchi T. Small centrum ovale infarcts on diffusion-weighted magnetic resonance imaging. Stroke 2002; 33 (06) 1541-1544
  • 4 Lang FF, Olansen NE, DeMonte F. et al. Surgical resection of intrinsic insular tumors: complication avoidance. J Neurosurg 2001; 95 (04) 638-650
  • 5 Türe U, Yaşargil MG, Al-Mefty O, Yaşargil DC. Arteries of the insula. J Neurosurg 2000; 92 (04) 676-687
  • 6 Kumabe T, Higano S, Takahashi S, Tominaga T. Ischemic complications associated with resection of opercular glioma. J Neurosurg 2007; 106 (02) 263-269