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

Radiation-induced moyamoya syndrome Transient ischemic attack Ventriculoperitoneal shunt

Journal

Surgical neurology international
ISSN: 2229-5097
Titre abrégé: Surg Neurol Int
Pays: United States
ID NLM: 101535836

Informations de publication

Date de publication:
2022
Historique:
received: 07 05 2022
accepted: 29 06 2022
entrez: 5 8 2022
pubmed: 6 8 2022
medline: 6 8 2022
Statut: epublish

Résumé

Patients with brain vascular disease and hydrocephalus may be predisposed to acute ischemic stroke in case of shunt dysfunction and subsequent increased intracranial pression. Patients with brain tumor may develop hydrocephalus as a consequence of obstruction of cerebrospinal fluid pathways and radiation-induced moyamoya syndrome secondary (RIMS) to radiotherapy (RT). A 15-year-old male patient, affected by hydrocephalus and RIMS, presented acute cerebral ischemia after an episode of shunt malfunction. The shunt was promptly revised and the areas of ischemia visible at magnetic resonance imaging significantly decreased. Children who receive RT for brain tumor, particularly if the circle of Willis region is involved, require close surveillance for the development of vasculopathy and consequent stroke. This surveillance must be even tighter if the patient has been treated with ventricular shunt for the possible synergistic interaction between the two causes on reducing cerebral perfusion and increasing the risk of acute ischemic events.

Sections du résumé

Background UNASSIGNED
Patients with brain vascular disease and hydrocephalus may be predisposed to acute ischemic stroke in case of shunt dysfunction and subsequent increased intracranial pression. Patients with brain tumor may develop hydrocephalus as a consequence of obstruction of cerebrospinal fluid pathways and radiation-induced moyamoya syndrome secondary (RIMS) to radiotherapy (RT).
Case Description UNASSIGNED
A 15-year-old male patient, affected by hydrocephalus and RIMS, presented acute cerebral ischemia after an episode of shunt malfunction. The shunt was promptly revised and the areas of ischemia visible at magnetic resonance imaging significantly decreased.
Conclusion UNASSIGNED
Children who receive RT for brain tumor, particularly if the circle of Willis region is involved, require close surveillance for the development of vasculopathy and consequent stroke. This surveillance must be even tighter if the patient has been treated with ventricular shunt for the possible synergistic interaction between the two causes on reducing cerebral perfusion and increasing the risk of acute ischemic events.

Identifiants

pubmed: 35928308
doi: 10.25259/SNI_434_2022
pii: 10.25259/SNI_434_2022
pmc: PMC9345112
doi:

Types de publication

Case Reports

Langues

eng

Pagination

306

Informations de copyright

Copyright: © 2022 Surgical Neurology International.

Déclaration de conflit d'intérêts

There are no conflicts of interest.

Références

World Neurosurg. 2020 Mar;135:118-129
pubmed: 31805403
Pediatr Neurol. 2015 Sep;53(3):211-5
pubmed: 26302700
Neurosurgery. 2012 May;70(5):1220-30; discussion 1231
pubmed: 22134142
J Neurosurg Pediatr. 2009 Nov;4(5):420-8
pubmed: 19877773
Pediatr Neurol. 2011 Jun;44(6):401-13
pubmed: 21555050
World Neurosurg. 2019 Jul;127:e843-e855
pubmed: 30954732
Pediatr Neurol. 2014 Jun;50(6):549-56
pubmed: 24739378
Radiat Res. 2021 Jul 1;196(1):1-16
pubmed: 33979447
Stroke. 2012 Nov;43(11):3035-40
pubmed: 22968468
Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1222-7
pubmed: 16626890
Pediatr Neurosurg. 2011;47(2):138-42
pubmed: 21893954
Neurology. 2007 Mar 20;68(12):932-8
pubmed: 17372129

Auteurs

Francesca Vitulli (F)

Department of Neurosciences, Neurosurgery Unit, AORN Santobono-Pausilipon Children's Hospital, Naples, Italy.
Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II University of Naples, Naples, Italy.

Pietro Spennato (P)

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

Domenico Cicala (D)

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

Giuseppe Mirone (G)

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

Maria Rosaria Scala (MR)

Department of Neurosciences, Neurosurgery Unit, AORN Santobono-Pausilipon Children's Hospital, Naples, Italy.
Department of Neurosciences and Reproductive and Dental Sciences, Division of Neurosurgery, Federico II University of Naples, Naples, Italy.

Giuseppe Cinalli (G)

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

Classifications MeSH