title: Diffuse cerebral vasospasm with ischemia after resection of a cerebellopontine angle primitive neuroectodermal tumor in a child.
abstract: This case report describes a 15-month-old female who developed diffuse cerebral vasospasm after resection of a cerebellopontine angle primitive neuroectodermal tumor. The patient developed an acute dense left hemiparesis 16 days postoperatively with partial right ptosis. Initial magnetic resonance imaging and diffusion study were unremarkable, though a magnetic resonance angiography 1 day later demonstrated severe intracranial vasospasm of both carotid and vertebral arteries. The vasospasm was confirmed with cerebral angiography. The patient progressed to bihemispheric infarcts with laminar necrosis despite combination therapy with anticoagulation, pharmacological hypertension, hypervolemia, and nimodipine. The clinical course, radiographic, and pathological findings are presented.
authors.affiliation: Department of Neurological Surgery, Miami Children's Hospital, Miami, Fla., USA.
authors.forename: T T
authors.initials: TT
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Ragheb
authors.forename: J C
authors.initials: JC
authors.lastname: Bruce
authors.forename: N
authors.initials: N
authors.lastname: Altman
authors.forename: G
authors.initials: G
authors.lastname: Morrison
mesh_terms: D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D002528:Cerebellar Neoplasms / Q000473:pathology / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D007223:Infant; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D017599:Neuroectodermal Tumors / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*