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Case Reports
. 2022 Dec 29;15(12):e252256.
doi: 10.1136/bcr-2022-252256.

Myocardial infarction after craniotomy for asymptomatic meningioma

Kristen Michelle Westfall  1 , Roger Navine Ramcharan  2 , Harry Linne Anderson 3rd  2
Affiliations
Case Reports

Myocardial infarction after craniotomy for asymptomatic meningioma

Kristen Michelle Westfall et al. BMJ Case Rep. .

Abstract

A man in his 40s with a history of coronary artery disease previously treated with a drug-eluting stent presented for elective craniotomy and resection of an asymptomatic but enlarging meningioma. During his craniotomy, he received desmopressin and tranexamic acid for surgical bleeding. Postoperatively, the patient developed chest pain and was found to have an ST-elevation myocardial infarction (MI). Because of the patient's recent neurosurgery, standard post-MI care was contraindicated and he was instead managed symptomatically in the intensive care unit. Echocardiogram on postoperative day 1 demonstrated no regional wall motion abnormalities and an ejection fraction of 60%. His presentation was consistent with thrombosis of his diagonal stent. He was transferred out of the intensive care unit on postoperative day 1 and discharged home on postoperative day 3.

Keywords: Adult intensive care; Drug therapy related to surgery; Ischaemic heart disease; Neurosurgery; Unwanted effects / adverse reactions.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
MRI brain demonstrating left frontal extra-axial mass measuring 2.3 cm × 5.3 cm with moderate local mass effect on left frontal and opercular regions.
Figure 2
Figure 2
ECG with ST elevations in leads I, aVL, V2–V6 and reciprocal change in leads III, aVR, aVF and V1.
Figure 3
Figure 3
Low-power and high-power images of mass resection pathology demonstrating meningothelial meningioma grade 1.
See this image and copyright information in PMC

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