Korean J Neurotrauma.  2017 Apr;13(1):39-44. 10.13004/kjnt.2017.13.1.39.

Vertebral Artery Injury in C2-3 Epidural Schwannoma Resection: A Case Report and Literature Review

Affiliations
  • 1Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. scrhim@amc.seoul.kr

Abstract

The incidence of vertebral artery (VA) injury (VAI) in posterior approach tumor resection surgery is extremely rare, but it can lead to serious complication. In this case, a 57-year-old man underwent surgery for resection of the tumor involving left epidural space and neural foramen at C2-3 level. Iatrogenic VAI occurred suddenly during tumor resection procedure using pituitary forceps. Immediate local hemostasis and maintaining of perfusion for reducing the risk of posterior circulation ischemia were performed. Intraoperative angiogram of both VA and emergent trapping embolization were done as well. It may reduce the risk of immediate postop complication, and further delayed occurrence. The patient had no complication after VAI by appropriate intraoperative management. Preoperative angiographic work up and preparation of endovascular team cooperation are positively necessary as well as a warning for the VAI during cervical spine surgery.

Keyword

Vertebral artery injury; Cervical spine surgery; Schwannoma; Embolization

MeSH Terms

Epidural Space
Hemostasis
Humans
Incidence
Ischemia
Middle Aged
Neurilemmoma*
Perfusion
Spine
Surgical Instruments
Vertebral Artery*
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