Brain Tumor Res Treat.  2021 Apr;9(1):26-30. 10.14791/btrt.2021.9.e4.

Surgical Experience of Posterior Fossa Meningioma in a Jehovah’s Witnesses Patient

• Eom KS

• KMID: 2515079
• DOI: http://doi.org/10.14791/btrt.2021.9.e4

Abstract

Unexpected bleeding is a common complication that can occur during surgery. This unexpected bleeding can be managed by checking the patients’ preoperative hemodynamic state or by autologous transfusion of an appropriate volume during surgery depending on the amount of blood loss and hemodynamic condition. However, patients like Jehovah’s Witnesses, who refuse autologous transfusions for religious reasons even in life-threatening situations, present a predicament for treating physicians. The author reports on a large meningioma on the posterior fossa of a Jehovah’s Witness patient who underwent surgery without autologous blood transfusion. There were no major problems other than the fear of unexpected massive bleeding. The surgeon’s attention and efforts to minimize bleeding during surgery seemed to be the most important factors for success.

Keyword

Jehovah’s Witnesses; Blood transfusion; Meningioma.

Figure

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  Fig. 1 (A) Gadolinium-enhanced axial and (B) sagittal MRI showing strong a homogeneous contrast-enhancing mass with a broad base in the tentorium of the left posterior fossa. C: The tumor shows increased relative cerebral blood volume on perfusion MRI.

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  Fig. 2 A: Left external carotid artery angiogram showing diffuse tumor straining and supply by the posterior branch of the middle meningeal and posterior auricular arteries. B: The venous phase of the left internal carotid artery shows left transverse and straight sinus occlusion due to the large tumor and normal venous drainage through the dominant right transverse sinus.

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  Fig. 3 (A) Gadolinium-enhanced sagittal and (B) coronal MRI obtained 6 months after operation showing that the meningioma had been completely removed and without recurrence.

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