The account alleges that a tumor embolization was performed using embolic devices within the middle meningeal artery 2 days before scheduled craniotomy surgery.Later on a craniotomy involving the contralateral side was performed, followed by rumor resection (simpson grade, ii).Dural defects were closed with duragen.Pathological diagnosis was transitional meningioma (who grade, i).No new neurological symptoms appeared, but sensory disturbance and paresis in the left upper and lower extremities developed 8 days after surgery.Mri showed cerebral infarction in the right parietal lobe.Cerebral venous thrombosis (cvt) was suspected, and drip infusion of heparin was started.Twelve hours later, however, seizures occurred on the left side of the body, and movement disorder (manual muscle testing, 2/5) and sensory disturbance on the left side of the body, left unilateral spatial neglect and apraxia developed.Mri showed that the infarct area in the right temporal lobe had become hemorrhagic, and magnetic resonance venography (mrv) revealed stenosis of the superior sagittal sinus just beneath the site of craniotomy.Superior sagittal sinus thrombosis was thus diagnosed.Drip infusion of heparin at 10000-12000 units/day was started, and then switched to direct oral anticoagulant (doac) therapy 1 week later.Blood testing showed no thrombotic predisposition.Mrv performed 3 weeks later showed recanalization of the superior sagittal sinus.The patient was transferred to another hospital with persisting left hemiplegia and sensory disturbance (modified rankin scale, grade 3) one and a half months after surgery.
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