CASE REPORTS   

Chirurgia 2014 December;27(6):357-61

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Management of wide openings in the ventricular system and exposure of large cerebral vessels in recurrent malignant gliomas with carmustine wafer implants

Yamamoto J., Kitagawa T., Ueta K., Miyaoka R., Umemura T., Nishizawa S.

Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan

A 67-year-old female with recurrent glioblastoma received surgery, the lateral ventricle (LV) was widely opened and the anterior cerebral artery (ACA) was exposed. Using a gelatin (cellulose) sheet with fibrin glue, the opening of the LV was completely closed, the ACA was covered, and a carmustine wafer was implanted into the resection cavity. Follow-up MRI showed no adverse effects. In cases with a wide opening of the ventricular system and exposure of the large cerebral vessels, complete closure of ventricular system, and the covering of vessels is essential before the use of a carmustine wafer to avoid unexpected fatal complications.