Bilateral MCA Infarct Following Resection of Giant Olfactory Groove Meningioma: A Rare Complication

There are various complications which have been described following excision of giant olfactory groove meningiomas and most of them have some pathophysiological basis and logic explaining their occurrence. Similarily, vascular insult to bilateral anterior cerebral arteries (ACA) could occur during surgery owing to its close proximity to the tumor. However, a 52 year old male who underwent complete resection of giant olfactory groove meningioma developed bilateral hemiparesis (right>left) 14 hours postoperatively following an episode of hypotension and was found to have bilateral MCA infarct on CT scan. Various investigations were done to clarify what must have gone wrong. In this case report, we discuss the possible underlying patho-physiological mechanisms for this peculiar and rare complication and try to find whether it is possible to predict its occurrence in future cases.