Download PDF
Journal of Pediatric Neurology 2021; 19(05): 364-368
DOI: 10.1055/s-0040-1721828
Case Report

Treatment of Increased Intracranial Pressure and Vasospasm after Subarachnoid Hemorrhage in a 9-Year-Old Child—A Case Report

Sarah-Hélène Müller 
1   Department of Anesthesiology and Critical Care, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Christian Taschner 
2   Department of Neuroradiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Stephan Meckel 
2   Department of Neuroradiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Ernst Mayerhofer 
3   Department of Neurology and Neurophysiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Roland Roelz 
4   Department of Neurosurgery, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Joachim Bansbach 
1   Department of Anesthesiology and Critical Care, Faculty of Medicine, University of Freiburg, Freiburg, Germany
› Author Affiliations Funding None.
› Further Information
Also available at
    Permissions and Reprints

Abstract

In this article, we reported a 9-year-old male child patient who suffered severe subarachnoid hemorrhage due to ruptured dissecting aneurysm of the left parieto-occipital artery. After endovascular occlusion of the aneurysm, increased intracranial pressure refractory to noninvasive therapy required secondary decompressive hemicraniectomy. Critical vasospasm and delayed neurological deterioration were treated by oral nimodipine and successful endovascular rescue therapy consisting of intra-arterial balloon dilatation.

Keywords

pediatric - intracranial - aneurysm - vasospasm

Availability of Data and Material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.


Authors' Contributions

S.-H.M. wrote the manuscript. C.T., S.M., E.M., R.R., and J.B. revised the manuscript. All authors contributed substantially to this work and all of them revised and agreed to the final version of the manuscript with full access to all data.


Consent for Publication

Written consent for publication of this report was obtained from the patient's parents.




Publication History

Received: 08 October 2020

Accepted: 20 November 2020

Article published online:
04 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Sorteberg A, Dahlberg D. Intracranial non-traumatic aneurysms in children and adolescents. Curr Pediatr Rev 2013; 9 (04) 343-352
    CrossrefPubMedSearch in Google Scholar
  • 2 Hetts SW, Narvid J, Sanai N. et al. Intracranial aneurysms in childhood: 27-year single-institution experience. AJNR Am J Neuroradiol 2009; 30 (07) 1315-1324
    CrossrefPubMedSearch in Google Scholar
  • 3 Krings T, Geibprasert S, terBrugge KG. Pathomechanisms and treatment of pediatric aneurysms. Childs Nerv Syst 2010; 26 (10) 1309-1318
    CrossrefPubMedSearch in Google Scholar
  • 4 Kim ST, Brinjikji W, Lanzino G, Kallmes DF. Neurovascular manifestations of connective-tissue diseases: a review. Interv Neuroradiol 2016; 22 (06) 624-637
    CrossrefPubMedSearch in Google Scholar
  • 5 Lasjaunias P, terBrugge KG, Berenstein A. Intracranial aneurysms in children. Surgical Neuroangiography Part 3: Clinical and Interventional Aspects in Children. Berlin, Heidelberg: Springer; 2006
    CrossrefSearch in Google Scholar
  • 6 Vaid VK, Kumar R, Kalra SK, Mahapatra AK, Jain VK. Pediatric intracranial aneurysms: an institutional experience. Pediatr Neurosurg 2008; 44 (04) 296-301
    CrossrefPubMedSearch in Google Scholar
  • 7 Krishna H, Wani AA, Behari S, Banerji D, Chhabra DK, Jain VK. Intracranial aneurysms in patients 18 years of age or under, are they different from aneurysms in adult population?. Acta Neurochir (Wien) 2005; 147 (05) 469-476 , discussion 476
    CrossrefPubMedSearch in Google Scholar
  • 8 Sanai N, Quinones-Hinojosa A, Gupta NM. et al. Pediatric intracranial aneurysms: durability of treatment following microsurgical and endovascular management. J Neurosurg 2006; 104 (2, Suppl:): 82-89
    PubMedSearch in Google Scholar
  • 9 Jabbarli R, Pierscianek D, Rölz R. et al. Endovascular treatment of cerebral vasospasm after subarachnoid hemorrhage: more is more. Neurology 2019; 93 (05) e458-e466
    CrossrefPubMedSearch in Google Scholar
  • 10 Heffren J, McIntosh AM, Reiter PD. Nimodipine for the prevention of cerebral vasospasm after subarachnoid hemorrhage in 12 children. Pediatr Neurol 2015; 52 (03) 356-360
    CrossrefPubMedSearch in Google Scholar
  • 11 Li K, Barras CD, Chandra RV. et al. A review of the management of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. World Neurosurg 2019; 126: 513-527
    CrossrefPubMedSearch in Google Scholar
  • 12 Liang J, Bao Y, Zhang H. et al. The clinical features and treatment of pediatric intracranial aneurysm. Childs Nerv Syst 2009; 25 (03) 317-324
    CrossrefPubMedSearch in Google Scholar
  • 13 Sharma BS, Sinha S, Mehta VS, Suri A, Gupta A, Mahapatra AK. Pediatric intracranial aneurysms-clinical characteristics and outcome of surgical treatment. Childs Nerv Syst 2007; 23 (03) 327-333
    CrossrefPubMedSearch in Google Scholar
  • 14 Hetts SW, English JD, Dowd CF, Higashida RT, Scanlon JT, Halbach VV. Pediatric intracranial aneurysms: new and enlarging aneurysms after index aneurysm treatment or observation. AJNR Am J Neuroradiol 2011; 32 (11) 2017-2022
    CrossrefPubMedSearch in Google Scholar
  • 15 Pendharkar AV, Guzman R, Dodd R, Cornfield D, Edwards MSB. Successful treatment of severe cerebral vasospasm following hemorrhage of an arteriovenous malformation. Case report. J Neurosurg Pediatr 2009; 4 (03) 266-269
    CrossrefPubMedSearch in Google Scholar