Massive Middle Cerebral Artery Infarction After Surgically Assisted Rapid Palatal Expansion: A Case Report

Abstract Dentofacial deformities have a significant impact upon a patient’s quality of life. Fortunately, these deformities can often be corrected through orthodontic and surgical treatment. In adults, transverse maxillary discrepancies are often corrected by performing a surgically assisted rapid palatal expansion (SARPE) procedure. This procedure is accompanied by many of the same complications involved in performing a LeFort I osteotomy. While major complications from maxillary surgery are uncommon, severe hemorrhage and cerebrovascular accidents are real risks accompanied by significant sequela. The purpose of this case report is to describe a case in which a patient suffered from a massive middle cerebral artery infarct following a SARPE procedure. We discuss possible etiology and pathogenesis of the complication. We also aim to remind surgeons of this rare complication so as to ensure prompt recognition and management to prevent delays in care.