Article Text

other Versions

PDF
Case report
Cerebral arterial angioplasty in a patient with Loeys–Dietz syndrome
  1. Christopher P Kellner1,
  2. Eric S Sussman1,
  3. Christopher Donaldson1,
  4. E Sander Connolly Jr2,
  5. Philip M Meyers1
  1. 1Department of Neurosurgery, Columbia University, New York, New York, USA
  2. 2Department of Neurological Surgery, Columbia University, New York, New York, USA
  1. Correspondence to Dr Christopher P Kellner, christopher.kellner{at}gmail.com

Abstract

A 14-year-old boy with Loeys–Dietz syndrome (LDS) had an acute neurologic decline 6 days after a subarachnoid hemorrhage. Cerebral angiography at presentation did not show an aneurysmal source of the hemorrhage. However, on post-bleed day 6 the patient experienced an acutely worsening headache and subsequently lost consciousness. Head CT showed new subarachnoid blood and repeat angiography demonstrated a basilar tip aneurysm. Endovascular coil embolization was performed and his neurologic status improved postoperatively until post-bleed day 9 when he became unresponsive. A CT angiogram demonstrated severe proximal vasospasm. After an unsuccessful attempt to treat the vasospasm medically, the patient was transported to the neurointerventional suite for intra-arterial vasodilator treatment, which also failed to ameliorate the vasospasm. The endovascular surgeons were then faced with the conundrum of attempting a high-risk cerebral angioplasty in a pediatric patient with LDS or returning to maximal medical treatment for severe refractory vasospasm.

  • Aneurysm
  • Angiography
  • Angioplasty
  • Balloon

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.