Lee T T, Ragheb J, Bruce J C, Altman N, Morrison G
Department of Neurological Surgery, Miami Children's Hospital, Miami, Fla., USA.
Pediatr Neurosurg. 1998 Dec;29(6):300-3. doi: 10.1159/000028741.
This case report describes a 15-month-old female who developed diffuse cerebral vasospasm after resection of a cerebellopontine angle primitive neuroectodermal tumor. The patient developed an acute dense left hemiparesis 16 days postoperatively with partial right ptosis. Initial magnetic resonance imaging and diffusion study were unremarkable, though a magnetic resonance angiography 1 day later demonstrated severe intracranial vasospasm of both carotid and vertebral arteries. The vasospasm was confirmed with cerebral angiography. The patient progressed to bihemispheric infarcts with laminar necrosis despite combination therapy with anticoagulation, pharmacological hypertension, hypervolemia, and nimodipine. The clinical course, radiographic, and pathological findings are presented.
本病例报告描述了一名15个月大的女性，她在切除桥小脑角原始神经外胚层肿瘤后发生了弥漫性脑血管痉挛。患者术后16天出现急性严重左侧偏瘫伴部分右侧上睑下垂。最初的磁共振成像和弥散研究未见异常，但1天后的磁共振血管造影显示颈内动脉和椎动脉均有严重的颅内血管痉挛。脑血管造影证实了血管痉挛。尽管采用了抗凝、药物性高血压、扩容和尼莫地平联合治疗，患者仍进展为双侧大脑半球梗死并伴有层状坏死。本文介绍了其临床病程、影像学和病理学表现。
