Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2005 Jan;7(1):84-9.
doi: 10.1215/S1152851704000614.

Cerebral edema associated with Gliadel wafers: two case studies

Emil L Weber  1 , Eric A Goebel
Affiliations
Case Reports

Cerebral edema associated with Gliadel wafers: two case studies

Emil L Weber et al. Neuro Oncol. 2005 Jan.

Abstract

While the introduction of carmustine wafers (Gliadel wafers) into the tumor resection cavity has been shown to be a beneficial therapy for malignant glioma, it is recognized that clinically significant cerebral edema is a potential adverse effect. Following are two clinical case reports demonstrating profound cerebral edema associated with implantation of Gliadel wafers. As a result, one of these individuals had premature death. A brief literature review is provided to assist in explaining the mechanisms by which clinically significant cerebral edema may develop.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Case 1 preoperative CT scan showing tumor configuration.
Fig. 2
Fig. 2
Case 1 preoperative MRI T2-weighted image depicts the associated edema and ventricular shift.
Fig. 3
Fig. 3
Case 1 postoperative day 19 CT scan demonstrating a marked midline shift with edema throughout the right hemisphere that is more pronounced than on preoperative images.
Fig. 4
Fig. 4
Case 1 postoperative day 33 CT scan demonstrating slight improvement over day 19 condition.
Fig. 5
Fig. 5
Case 1 postoperative day 35 CT demonstrating increased edema throughout the right hemisphere and further shift of the midline structure.
Fig. 6
Fig. 6
Case 2 preoperative MRI T1-weighted image revealing a mass lesion in the high left frontal–parietal area with minimal edema.
Fig. 7
Fig. 7
Case 2 preoperative MRI T2-weighted image revealing a mass lesion in the high left frontal–parietal area with minimal edema.
Fig. 8
Fig. 8
Case 2 postoperative day 2 CT scan demonstrating increased edema in the left hemisphere.
Fig. 9
Fig. 9
Case 2 postoperative day 5 CT scan demonstrating increasing edema of the left hemisphere with mass effect.
Fig. 10
Fig. 10
Case 2 postoperative day 7 CT scan demonstrating a decrease in the amount of cerebral edema.
See this image and copyright information in PMC

References

    1. Brem H, Mahaley MS, Jr, Vick NA, Black KL, Schold SC, Jr, Burger PC, Friedman AH, Ciric IS, Eller TW, Cozzens JW, Kenealy JN. Interstitial chemotherapy with drug polymer implants for the treatment of recurrent gliomas. J Neurosurg. 1991;74:441–446. - PubMed
    1. Brem H, Tamargo RJ, Olivi A, Pinn M, Weingart JD, Wharam M, Epstein JI. Biodegradable polymers for controlled delivery of chemotherapy with and without radiation therapy in the monkey brain. J Neurosurg. 1994;80:283–290. - PubMed
    1. Brem H, Piantadosi S, Burger PC, Walker M, Selker R, Vick NA, Black K, Sisti M, Brem S, Mohr G, Muller P, Morawetz R, Schold SC for the Polymer-Brain Tumor Treatment Group. Placebocontrolled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. Lancet. 1995;345(8956):1008–1012. - PubMed
    1. Dang WB, Daviau T, Ying P, Zhao Y, Nowotnik D, Clow CS, Tyler B, Brem H. Effects of Gliadel wafer initial molecular weight on the erosion of wafer and release of BCNU. J Control Release. 1996;42(1):83–92.
    1. Fleming AB, Saltzman WM. Pharmacokinetics of the carmustine implant. Clin Pharmacokinet. 2002;41:403–419. - PubMed

Publication types

MeSH terms

Substances