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Cerebral vasospasm after tumor resection. A case report

G K Bejjani1, D H Duong, M Kalamarides

  • 1Department of Neurosurgery, George Washington University, Washington, DC 20037, USA.

Neuro-Chirurgie
|January 1, 1997
PubMed
Summary

Cerebral vasospasm, a treatable cause of delayed neurological decline after brain tumor surgery, was identified in a pediatric patient. Early recognition and treatment of this condition are crucial for improving patient outcomes.

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Area of Science:

  • Neurology
  • Neurosurgery
  • Pediatric Neurology

Background:

  • Symptomatic cerebral vasospasm can occur after resection of tumors near the basal cisterns, leading to delayed neurological deterioration.
  • This condition is potentially treatable but may be overlooked, negatively impacting patient outcomes.

Observation:

  • A 6-year-old girl presented with diplopia, diagnosed with a third nerve schwannoma.
  • Postoperatively, she experienced mental status deterioration, with imaging suggesting a vascular etiology.
  • Cerebral angiography confirmed vasospasm in the right internal carotid, middle, and posterior cerebral arteries.

Findings:

  • This case represents the youngest reported patient experiencing vasospasm after brain tumor resection.
  • The patient developed delayed neurological deterioration consistent with cerebral vasospasm.

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Implications:

  • A high index of suspicion for vasospasm is essential in patients with delayed deterioration after basal cistern tumor surgery.
  • Early diagnosis via cerebral angiography and prompt treatment with hyperdynamic therapy and angioplasty can reverse deficits and improve outcomes.