Journal article
Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case
Journal of neurosurgery. Case lessons, v 5(22), 22435
29 May 2023
PMID: 37249138
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND The Responsive Neurostimulation (RNS) system is an implantable device for patients with drug-resistant epilepsy who are not candidates for resection of a seizure focus. As a relatively new therapeutic, the full spectrum of adverse effects has yet to be determined. A literature review revealed no previous reports of cerebral vasospasm following RNS implantation. OBSERVATIONS A 35-year-old man developed severe angiographic and clinical vasospasm following bilateral mesial temporal lobe RNS implantation. He initially presented with concerns for status epilepticus 8 days after implantation. On hospital day 3, a decline in his clinical examination prompted imaging studies that revealed a left middle cerebral artery (MCA) stroke with angiographic evidence of severe vasospasm of the left internal carotid artery (ICA), MCA, anterior cerebral artery (ACA), and right ICA and ACA. Despite improvements in angiographic vasospasm after appropriate treatment, a thrombus developed in the posterior M2 branch, requiring mechanical thrombectomy. Ultimately, the patient was stabilized and discharged to a rehabilitation facility with residual cognitive and motor deficits. LESSONS Cerebral vasospasm as a cause of ischemic stroke after uneventful RNS implantation is exceedingly rare, yet demands particular attention given the potential for severe consequences and the growing number of patients receiving RNS devices.
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Details
- Title
- Vasospasm secondary to responsive neurostimulator placement: a previously unreported complication. Illustrative case
- Creators
- Brandon Rogowski - Drexel UniversityAaron Miller - College Station Medical CenterBrian F. Saway - University of South CarolinaJeffrey Wessell - University of South CarolinaNathan C. Rowland - University of South CarolinaJonathan Ross Lena - University of South CarolinaWilliam A. Vandergrift - University of South Carolina
- Publication Details
- Journal of neurosurgery. Case lessons, v 5(22), 22435
- Publisher
- Amer Assoc Neurological Surgeons
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001422041200002
- Scopus ID
- 2-s2.0-85161364825
- Other Identifier
- 991022207060304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery