Intraparenchymal fiberoptic intracranial pressure monitoring and decompressive craniectomy in meningioma case with critical intracranial pressure: A case report during COVID-19 pandemic.
CNS, Central Nervous System
COVID-19, Corona Virus Disease 2019
Case report
DC, Decompressive Craniectomy
Decompressive Craniectomy
GCS, Glasgow Coma Scale
ICP monitoring
ICP, Intracranial Pressure
ICU, Intensive Care Unit
Meningioma
TBI, Traumatic Brain Injury
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
15
05
2022
revised:
25
06
2022
accepted:
25
06
2022
pubmed:
6
7
2022
medline:
6
7
2022
entrez:
5
7
2022
Statut:
ppublish
Résumé
Meningioma is a slow-growing tumor that can cause neurological emergency due to intracranial hypertension. The definitive therapy is indeed emergency resection, but it is not always possible in several countries due to limited capacity and/or capability of the emergency operating room. The use of intraparenchymal fiberoptic intracranial pressure (ICP) monitoring and decompressive craniectomy (DC) in cases of brain tumors might be possible, but it is uncommon. We report a meningioma patient in whom immediate meningioma resection was considered too risky due to intensive care unit (ICU) shortage during COVID-19 pandemic and, therefore, underwent these procedures as life-saving measures. A 24-year-old man was brought to the emergency room with a chief complaint of seizure. Physical examination was notable for decreased consciousness (Glasgow Coma Scale (GCS) 11) and a dilated left pupil with intact light reflex. A contrasted Brain CT Scan revealed extra-axial mass on the left sphenoid with extensive tentacle edema, which pushed the midline structures 2 cm toward the contralateral side. The patient was diagnosed with Left Sphenoid Meningioma. We decided to perform intraparenchymal fiberoptic ICP monitor insertion and DC considering the situation, device availability, safety, and efficacy. The patient slowly regained consciousness in the recovery room after the procedure. The best-observed GCS was 12. Two weeks afterward, the patient came back to our outpatient clinic neurologically intact. The patient was then planned for elective tumor resection. ICP monitoring and DC are not commonly performed on brain tumor cases. However, in suboptimal situations, these procedures might save lives. The present case showed that ICP monitor and DC were helpful in times of ICU shortage.
Identifiants
pubmed: 35789669
doi: 10.1016/j.ijscr.2022.107364
pii: S2210-2612(22)00610-1
pmc: PMC9242682
pii:
doi:
Types de publication
Case Reports
Langues
eng
Pagination
107364Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors report there are no competing interests to declare.
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