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Supratentorial arterial ischemic stroke following cerebellar tumor resection in two children
Coriene E Catsman-Berrevoets1, Melanie van Breemen, Marie Lise van Veelen
1Department of Child Neurology, Erasmus MC/Sophia Children Hospital, Rotterdam, The Netherlands. c.catsman@erasmusmc.nl
Insights
Two children experienced ischemic strokes after cerebellar tumor resection. The strokes occurred in the middle cerebral artery territory, potentially linked to posterior fossa syndrome.
Area of Science:
- Neurology
- Pediatric Oncology
- Neurosurgery
Background:
- Cerebellar tumor resection is a complex neurosurgical procedure.
- Ischemic strokes are a potential, though uncommon, complication following neurosurgery.
- Understanding post-operative neurological complications is crucial for patient management.
Observation:
- Two pediatric cases of ischemic stroke in the middle cerebral artery (MCA) territory are presented.
- Strokes occurred subacutely, 7 and 11 days post-resection of cerebellar tumors.
- One child experienced a second, contralateral MCA infarction 5 days after the initial event.
Findings:
- No specific cause or risk factor beyond the surgical procedure was identified for the ischemic strokes.
- The clinical presentation of stroke onset was similar to 'posterior fossa syndrome'.
- This suggests a potential shared pathophysiological mechanism between cerebellar surgery complications and posterior fossa syndrome.
Implications:
- Cerebellar tumor resection may carry a risk of delayed ischemic stroke in the MCA territory.
- The findings suggest a possible link between cerebellar surgery and posterior fossa syndrome mechanisms.
- Further research is warranted to elucidate the underlying mechanisms and optimize preventative strategies for post-operative stroke.
Abstract:
We describe two children who developed ischemic strokes in the territory of the middle cerebral artery, one 7 days and one 11 days after resection of a cerebellar tumor. In the first child, another infarction occurred in the territory of the contralateral middle cerebral artery 5 days after the first stroke. No specific cause or underlying risk factor other than the surgical procedure was found. The subacute clinical course at stroke onset resembled that of the 'posterior fossa syndrome', suggesting a common underlying mechanism.
