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Cerebral vasospasm after endoscopic fenestration of a temporal arachnoid cyst in a child—a case report and review of the literature

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Abstract

Introduction

Intracranial arachnoid cysts (ACs) represent rare extra-axial CSF-containing lesions. Surgical management mainly depends on the cyst location and its size. Nevertheless, pure endoscopic fenestration represents a relatively straightforward and safe technique, and—in most cases—the treatment of choice for symptomatic intracranial ACs. The postoperative complication rate of the procedure is low including subdural hematomas, hygromas, and intraparenchymal hemorrhages. Symptomatic cerebral vasospasm after endoscopic treatment of ACs is a very uncommon event.

Case report/Results

To the authors’ knowledge, this adverse event in children has not yet been reported in the literature yet. The authors present a case of a 9-year-old child developing an early symptomatic cerebral vasospasm with an insignificant secondary ischemia following endoscopic fenestration of a large temporal arachnoid cyst.

Discussion

The clinical approach, possible pathogenesis, and the therapeutic strategy is discussed particularly with regard to the literature.

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Abbreviations

AC:

Arachnoid cyst

CSF:

Cerebrospinal fluid

FLAIR:

fluid attenuated inversion recovery

ICA:

Internal carotid artery

ICU:

Intensive Care Unit

MAP:

Middle arterial pressure

MRI:

Magnetic Resonance Imaging

SAH:

Subarachnoid hemorrhage

SPECT:

Single photon emission computed tomography

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Financial disclosure

Joachim Oertel acts as consultant to Karl Storz SE Company. Stefan Linsler received honorarium for presentations from Karl Storz SE Company. Besides this, the authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript. No funding was received for this research.

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Authors and Affiliations

  1. Department of Neurosurgery, Faculty of Medicine, Saarland University Medical Center and Saarland University, Gebäude 90.5, 66421, Homburg/Saar, Germany

    Anna Prajsnar-Borak, Joachim Oertel, Sebastian Antes & Stefan Linsler

  2. Department of Neuroradiology, Faculty of Medicine, Saarland University Medical Center and Saarland University, Homburg, Germany

    Umut Yilmaz

Authors
  1. Anna Prajsnar-Borak
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  2. Joachim Oertel
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  3. Sebastian Antes
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  4. Umut Yilmaz
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  5. Stefan Linsler
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Corresponding author

Correspondence to Joachim Oertel.

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Prajsnar-Borak, A., Oertel, J., Antes, S. et al. Cerebral vasospasm after endoscopic fenestration of a temporal arachnoid cyst in a child—a case report and review of the literature. Childs Nerv Syst 35, 695–699 (2019). https://doi.org/10.1007/s00381-018-4011-7

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