NCMP-18. POST-OPERATIVE NEUROLOGICAL DEFICIT /VASOSPASM AFTER CRANIOPHARYNGIOMA SURGERY: EVALUATION OF CAUSATIVE FACTORS AND PREVENTION

Abstract

Abstract INTRODUCTION Referring to a rare post-operative complication associated with craniopharyngioma surgery, Vasospasm. A number of possible causative factors have been postulated, like tumour encasing vessel, handling of vessels during surgery, but none have been able to explain delayed complication. Thus, we have evaluated series of patients operated in a single centre, to look for the possible aetiology METHODS Patient’s data have been collected retrospectively in the past 4 year, from a single centre, and cases that developed post-operative neurological deficit/vasospasm, proven clinically and/or radiology were included. Of 116 patients operated 6 were found to have clinical deterioration, and were confirmed using transcranial Doppler and/or radiologically demonstrable vasospasm. Each case was analysed retrospectively, and relevant variables were studied. RESULTS Patients developed neurological deficit/vasospasm ranging from Post-operative day 2 to second week after surgery. 1 expired, 2 improved over time, and 3 had persisting deficits. On evaluation, fluid balance showed changes, with serum Sodium levels. However, change of status from high volume status to low volume status was seen in almost all. CONCLUSIONS Development of post-operative neurological deficit/vasospasm is usually a cumulative result of some intraoperative insult like vessel handling, which could be a predisposing factor, and various post-operative factors like change In volume status, serum electrolytes levels, hormone status levels. Most important of all is to have an early and low threshold level to diagnose it, as early detection and action may a significant and possibly preventable morbidity or mortality