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2015 ; 2
(1
): 40-45
Nephropedia Template TP
gab.com Text
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English Wikipedia
Double-edged Sword in the Placement of Carmustine (BCNU) Wafers along the
Eloquent Area: A Case Report
#MMPMID28663961
Kuramitsu S
; Motomura K
; Natsume A
; Wakabayashi T
NMC Case Rep J
2015[Jan]; 2
(1
): 40-45
PMID28663961
show ga
Although direct Gliadel(®) wafer implantation into the resection cavity has been
shown to significantly improve survival in patients with high-grade gliomas,
several complications have been associated with the implantations of Gliadel
wafers, including brain edema, healing delay, cerebral spinal fluid leak,
intracranial infections, and cyst formation. The brain edema that is associated
with Gliadel wafer implantation might result in neurological deficits and
significant morbidities and mortalities. In particular, it is not clear if they
should be placed in the eloquent areas, such as language areas, motor areas, and
areas related to cognitive function, even if these areas contain a remnant tumor.
Here, we present a case of profound brain edema along the pyramidal tract due to
Gliadel wafer implantation, which resulted in severe neurological deficits. This
treatment represents a double-edged sword due to the possibility of severe
symptomatic brain edema along the eloquent area, even though Gliadel wafers might
be effective in controlling local tumor growth. We should keep in mind that
Gliadel wafer placement in eloquent areas may result in severe disadvantages to
patients and a loss of their quality of life.