Cerebral vasospasm after endoscopic fenestration of a temporal arachnoid cyst in a child—a case report and review of the literature

Prajsnar-Borak, Anna; Oertel, Joachim; Antes, Sebastian; Yılmaz, Ümüt; Linsler, Stefan

doi:10.1007/s00381-018-4011-7

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Case reports and single-institution reviews have described varied treatments ranging from CCBs (oral, IV, or intraarterial) and milrinone to angioplasties and bypasses. 22,[31][32][33][34] The treatments for vasospasm in the adult population are also variable with a range of reported efficacies (Table 2). 15,[35][36][37] Oral nimodipine has been shown to improve functional outcomes after aSAH in adult patients, though it has not shown a concordant effect on radiographic vasospasm.…”

Section: Discussionmentioning

confidence: 99%

First use of intraventricular nicardipine in a pediatric patient with vasospasm secondary to meningitis: illustrative case

Horak,

Patel,

Abdelmageed

et al. 2024

Journal of Neurosurgery: Case Lessons

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BACKGROUND Cerebral vasospasm is commonly associated with adult aneurysmal subarachnoid hemorrhage but can develop in children. The standard vasospasm treatment includes induced hypertension, avoidance of hypovolemia, systemic use of the calcium channel blocker (CCB) nimodipine, and cerebral angiography for intraarterial therapy. Emerging treatments in adults, such as intraventricular CCB administration, have not been investigated in children. This study demonstrates the successful use of an intraventricular CCB in a pediatric patient with refractory vasospasm secondary to meningitis. OBSERVATIONS A 12-year-old female presented with Streptococcus pneumoniae meningitis and ventriculitis with refractory symptomatic cerebral vasospasm. She received a 5-day course of intrathecal nicardipine through an existing external ventricular drain. Her clinical status, transcranial Doppler studies, and radiography improved. Treatment was well tolerated. LESSONS Pediatric vasospasm is uncommon and potentially devastating. The management of vasospasm in adults occurs frequently. Principles of this management are adapted to pediatric care given the rarity of vasospasm in children. The use of intraventricular nicardipine has been reported in the care of adults with level 3 evidence. It has not been adequately reported in children with refractory vasospasm. Here, the first use of intraventricular nicardipine in treating pediatric cerebral vasospasm in the setting of meningitis is described and highlighted.

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Section: Discussionmentioning

confidence: 99%

First use of intraventricular nicardipine in a pediatric patient with vasospasm secondary to meningitis: illustrative case

Horak,

Patel,

Abdelmageed

et al. 2024

Journal of Neurosurgery: Case Lessons

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“…In most cases, DCI begins four days after bleeding, the narrowing is maximal at 6-8 days, and it resolves up to 2-3 weeks after bleeding [5]. Although well characterized in aneurysmal SAH, DCI can occur after hemorrhage due to trauma, arteriovenous malformations (AVM), tumors, coagulopathies, vasculitis, and intracranial surgeries [5,7,14,15]. DCI is rare in childhood but can lead to severe neurological de cits or death [7,14].…”

Section: Introductionmentioning

confidence: 99%

Balloon angioplasty for the treatment of cerebral vasospasm

Demartini

Maeda

Frizon

et al. 2023

Preprint

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Objective Cerebral vasospasm, or delayed cerebral ischemia (DCI), is a subarachnoid hemorrhage complication that increases morbidity and mortality. DCI treatment with balloon percutaneous transluminal angioplasty (PTA) in adults is well known, but data in preschool children are scarce because of its rarity. In addition, the smaller diameters and fragility of the vessels in childhood might lead to complications. This study presents two cases of DCI in children treated with balloon angioplasty. Therefore, it may contribute to a better understanding of the role of PTA as an effective treatment modality in this population.Methods Two children (3 and 5-year-old) with DCI were treated with balloon PTA after aneurysmal subarachnoid hemorrhage.Results Both patients survived without complications or new infarction.Conclusions Balloon angioplasty for proximal DCI may improve clinical outcomes in selected pediatric patients. Further studies are needed to clarify the best candidates, materials and techniques.

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Controversies in the Treatment of Arachnoid Cysts with Special Emphasis on Temporal Arachnoid Cysts

Peraud

Ibel

2023

Advances and Technical Standards in Neurosurgery

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Cerebral vasospasm after endoscopic fenestration of a temporal arachnoid cyst in a child—a case report and review of the literature

Cited by 5 publications

References 21 publications

First use of intraventricular nicardipine in a pediatric patient with vasospasm secondary to meningitis: illustrative case

First use of intraventricular nicardipine in a pediatric patient with vasospasm secondary to meningitis: illustrative case

Balloon angioplasty for the treatment of cerebral vasospasm

Controversies in the Treatment of Arachnoid Cysts with Special Emphasis on Temporal Arachnoid Cysts

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