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Cerebral Digital Subtraction Angiography in Acute Intracranial Hemorrhage: Considerations in Critically Ill Children
D B Harrar1, L R Sun2, M Goss3
1Division of Neurology, 8404Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA.
Insights
Cerebral digital subtraction angiography (DSA) is a safe and valuable tool for diagnosing and managing cerebrovascular disorders in critically ill children, particularly those with acute intracranial hemorrhage.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Critical Care Medicine
Background:
- Cerebrovascular disorders are a significant cause of illness and death in children.
- Prompt diagnosis and management are crucial for improving outcomes.
Purpose of the Study:
- To explore the utility of cerebral digital subtraction angiography (DSA) in critically ill children with acute intracranial hemorrhage (ICH).
- To highlight DSA's role in managing specific conditions like aneurysm rupture, arteriovenous malformation rupture, and cerebral vasospasm.
Main Methods:
- A case-based approach was used to review the application of cerebral DSA.
- The study focused on critically ill pediatric patients.
Main Results:
- Cerebral DSA is a safe and minimally invasive diagnostic technique in pediatric patients.
- DSA aids in the diagnosis and acute management of various cerebrovascular conditions in children with ICH.
Conclusions:
- Cerebral DSA is an underutilized but valuable technique for pediatric cerebrovascular disorders in critical care.
- Consider cerebral DSA as part of comprehensive care for critically ill children with acute ICH.
Abstract:
Cerebrovascular disorders are an important cause of morbidity and mortality in children. Although minimally invasive, cerebral digital subtraction angiography (DSA) has been shown to be safe in children and is a valuable, and perhaps underutilized, technique for the diagnosis and management of pediatric cerebrovascular disorders in the critical care setting. Through a case-based approach, we explore the utility of DSA in critically ill children with acute intracranial hemorrhage (ICH). We discuss the use of DSA in the acute management of aneurysm and arteriovenous malformation rupture as well as cerebral vasospasm. Those caring for critically ill children with acute ICH should consider cerebral DSA as part of a comprehensive approach to the diagnosis and management of these conditions.
