경부 종양이 침윤된 경동맥의 풍선 폐색 후 발생한 후대뇌동맥 경색증 1예

Abstract

Background : Direct invasion or encasement of the carotid artery may occur in advanced cases of squamous cell carcinoma in the neck. Resection of these lesions with involved common or internal carotid artery continues to elicit controversy in the literature and carries a significant mortality and neurologic morbidity. Case Report:We present an unexpected posterior cerebral artery infarct after permanent internal carotid artery balloon occlusion because of an anatomical variant, called fetal-type posterior cerebral artery, during preoperative evaluation in a patient with a metastatic neck tumor. Conclusion : Carotid artery invasion by malignancy portends a poor prognosis. Carotid artery resection can provide reasonable palliation. The head and neck surgeon faces a d i fficult dilemma because of its high mortality and neurologic morbidity. There have been so many efforts to reduce the neurologic morbidity through the preoperative studies such as four-vessel angiography, temporary balloon occlusion test, intraoperative electroencephalographic monitoring and single-photon emission computed tomographic scanning. This experience, although limited, suggests that to prevent unexpected complications as in this case, it needs more attentive involvement of neurologists as a consultant.Korean Journal of Stroke 1999;1(1):91~94