title: Severe postoperative vasculitis of the central nervous system in a child with arteriovenous malformation: case report.
abstract: BACKGROUND
  Cerebral vasculitis is very rare complication after craniotomy. We report a case and discuss the etiology, diagnosis, and treatment of this complication.
  
  
  METHODS
  A 12-year-old boy was admitted because of a consciousness disturbance due to a ruptured AVM. Computed tomography revealed a left parietal subcortical hematoma. No apparent nidus was detected on the angiography findings, but AVM was suspected. After resection of the hematoma, the patient did not recover consciousness, and his high fever continued. Despite postoperative induced hypothermia, progressive multiple cerebral infarctions occurred. Postoperative angiography showed multiple arterial narrowing, and a "string of beads" phenomenon was observed in the anterior and posterior circulation in addition to the residual AVM. After administering steroid therapy, he recovered consciousness, but had a severe disability. After angiography, which was performed 1 year after onset, an improvement of the vasculitis and the complete occlusion of AVM were observed.
  
  
  CONCLUSIONS
  We should therefore include cerebral vasculitis in the differential diagnosis when encountering a case with an unusual progressive stroke because a timely diagnosis and aggressive treatment are of critical importance for a successful recovery in such patients.
authors.affiliation: Department of Neurosurgery, Oita University, Yufu, Oita 879-5593, Japan. abet@med.oita-u.ac.jp
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nagai
authors.forename: Tohru
authors.initials: T
authors.lastname: Kamida
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Wakabayashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ishii
authors.forename: Minoru
authors.initials: M
authors.lastname: Fujiki
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D002543:Cerebral Hemorrhage / Q000209:etiology / Q000601:surgery*; D002648:Child; D003399:Craniotomy / Q000009:adverse effects*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000601:surgery*; D008297:Male; D020293:Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy