The incidence of cerebral venous infarctions is not high, but this condition can cause serious complications. This paper summarizes the cases of serious complications after cerebral venous infarctions and proposes corresponding treatment strategies.
A retrospective analysis was performed on 5 patients that had severe complications secondary to injury or sacrifice of related veins during the resection of different intracranial lesions (cerebellopontine angle, lateral ventricle, frontal lobe, falx parietal lobe, frontal parietal lobe). There were 2 males and 3 females, aged 34-58 years. Routine CT and MRI/MRV examinations were performed before the operation, and the diagnoses were a hemifacial spasm, a meningioma of the lateral ventricle, a hemangioma, a falx meningioma and a glioma. Postoperative CT examinations were performed to understand the intracranial conditions of the patients.
Five cases had injuries to associated veins, which included the cerebellar cortical vein, internal cerebral vein, middle frontal vein, straight sinus, and postfrontal vein, during the operations. There were 2 cases of venous infarctions, 3 cases of hemorrhagic infarctions, 2 cases who had conservative treatment, 3 cases who had surgical treatment, 1 case who died (the hemifacial spasm), 1 case who had a vegetative survival (the lateral ventricular meningioma), and 3 cases with good recoveries (the hemangioma, falx meningioma, and glioma).
Surgeons should pay more attention to intracranial vein injuries during procedures. Acute neurological dysfunction or even death may occur after these injuries. Surgeons should closely monitor the condition of the patient and proceed with surgical intervention if necessary. The prognosis is usually good for these surgery cases, but the prognosis can be poor if important veins are injured. The key to avoiding cerebral venous infarctions is to preserve the integrity of the veins to the greatest extent during the operation.