The Delayed Neurological Deficit: Problems of Vessels during Skull Base Surgery

The author retrospectively surveyed delayed neurological deficits after neurosurgery procedures. The aim of this study was to analyze delayed neurological deficits following surgical resection of any pathological substances. After skull base surgery procedures, neurological deficits develop without destruction of anatomical structures, cranial nerves, brain tissue, and the inner ear. These deficits develop over 7–72 hours after surgery. The author studied the anatomical problems of vascularized nerves and nervous tissue (arteries, veins, capillary rete) and constructed a theory about the vessel lesions. He discusses the hematological problems and different approaches to treat these problems (e.g., thrombolysis, arterial-capillary-venous hypertensive syndrome, edema, hemorrhage, vasospasm). The author reviews the literature about delayed neurological deficits after skull base procedures and looks at preventive treatment options to use before these problems arise.