Successful treatment of severe cerebral vasospasm following hemorrhage of an arteriovenous malformation. Case report.
The authors describe the case of a 13-year-old boy who presented with an intraventricular hemorrhage caused by a left trigonal arteriovenous malformation. After an initial recovery, the patient experienced complete right-sided paresis on posthemorrhage Day 6. Severe cerebral vasospasm was found on MR angiography and confirmed on conventional cerebral angiography. Intraarterial nicardipine injection and balloon angioplasty were successfully performed with improved vasospasm and subsequent neurological recovery. Cerebral vasospasm should be considered in the differential diagnosis for neurological deterioration following an arteriovenous malformation hemorrhage, and aggressive treatment can be administered to prevent ischemia and further neurological deficits.
Pendharkar
Arjun V
AV
Divisions of Pediatric Neurosurgery, Lucile packard Children's Hospital, Standford School of Medicine, Stanford, California 94305-5327, USA.
Guzman
Raphael
R
Dodd
Robert
R
Cornfield
David
D
Edwards
Michael S B
MS
D000293:Adolescent; D000800:Angioplasty, Balloon; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D009529:Nicardipine / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
D014665:Vasodilator Agents; D009529:Nicardipine