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Acute ischemic stroke secondary to ventriculoperitoneal shunt dysfunction in a child with Moyamoya syndrome

Francesca Vitulli1,2, Pietro Spennato1, Domenico Cicala3

  • 1Department of Neurosciences, Neurosurgery Unit, AORN Santobono-Pausilipon Children's Hospital, Naples, Italy.

Surgical Neurology International
|August 5, 2022
PubMed

Insights

Patients with hydrocephalus and radiation-induced moyamoya syndrome are at high risk for acute ischemic stroke due to shunt malfunction. Prompt shunt revision can significantly reduce ischemic areas.

Area of Science:

  • Neuroscience
  • Pediatric Oncology
  • Vascular Neurology

Background:

  • Brain vascular disease and hydrocephalus increase stroke risk, especially with shunt dysfunction.
  • Brain tumors can cause hydrocephalus and radiation-induced moyamoya syndrome (RIMS) after radiotherapy (RT).

Observation:

  • A 15-year-old male with hydrocephalus and RIMS experienced acute cerebral ischemia following shunt malfunction.
  • The patient's shunt was revised, leading to a significant decrease in visible ischemic areas on MRI.

Findings:

  • Shunt malfunction in patients with hydrocephalus and RIMS can precipitate acute ischemic stroke.
  • Effective management, including prompt shunt revision, can reverse ischemic changes.

Implications:

  • Children treated with RT for brain tumors, especially involving the circle of Willis, need vigilant monitoring for stroke.
  • Patients with shunts require even closer surveillance due to synergistic risks of vasculopathy and reduced cerebral perfusion.
Abstract

Keywords:
Radiation-induced moyamoya syndromeTransient ischemic attackVentriculoperitoneal shunt

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