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Case Report
A case of perforator area infarction during maintenance chemotherapy for insular glioma with bevacizumab
1 MD, Director, Department of Neurosurgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
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Akira Tempaku
7-5 Inada-cho-kisen, Obihiro, Hokkaido 080-0833,
Japan
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Article ID: 100133Z06AT2025
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Tempaku A. A case of perforator area infarction during maintenance chemotherapy for insular glioma with bevacizumab. Case Rep Int 2025;14(2):1–4.ABSTRACT
Introduction: Glioblastoma multiforme is one of the most malignant central nervous system neoplasms. Maintaining good daily living activities during the tumor progression-free survival period is desirable. Neurological dysfunctions resulting from surgical treatment-related deficiencies or ischemic stroke during the established treatment protocol should be avoided.
Case Report: A 66-year-old woman was diagnosed with glioblastoma multiforme in the right insula. She underwent chemotherapy and radiotherapy following surgical resection. Following the initial standard treatment, she received maintenance chemotherapy, which included the administration of the antiangiogenic agent bevacizumab. During this period, she experienced a cerebral infarction with severe hemiplegia. Sixteen administrations of the antiangiogenic agent later, the perforator of the right middle cerebral artery became infarcted.
Conclusion: Antiangiogenic agents are known to cause vascular infarction complications. However, small vessel occlusion is rarely observed with this type of therapy. Previous reports on complications involving small vessel infarction show that adverse events typically occur several days after treatment, with one exception. This case demonstrates the rare occurrence of cerebral infarction shortly after treatment with an antiangiogenic agent.
Keywords: Bevacizumab, Cerebral infarction, Complication, Glioma
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Acknowledgments
The author thanks medical stuffs of Hokuto Hospital to support clinical treatment and care for the patient.
Author ContributionsAkira Tempaku - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthor declares no conflict of interest.
Copyright© 2025 Akira Tempaku. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
