Turkish Neurosurgery 2015 , Vol 25 , Num 5
A Right Middle Cerebral Artery Infarct After Frontal Eosinophilic Granuloma Resection in an 8-Year-Old Boy with Factor V Leiden
Ertugrul CAKIR1, Erhan ARSLAN2, Ugur YAZAR1, Gokce Pinar REIS3
1Karadeniz Technical University, School of Medicine, Department of Neurosurgery, Trabzon, Turkey
2Giresun University, School of Medicine, Department of Neurosurgery, Giresun, Turkey
3Karadeniz Technical University, School of Medicine, Department of Pediatric Hematology, Trabzon, Turkey
DOI : 10.5137/1019-5149.JTN.10918-14.1 Stroke in children is relatively uncommon. We describe an 8-year-old boy diagnosed with primary eosinophilic granuloma (EG) of the frontal bone. After excision of the EG, the postoperative course was eventful. The patient had an acute right middle cerebral artery (MCA) infarct and had been comatose with a diminished Glasgow Coma Scale (GCS) score of 5. Urgent decompressive hemicraniectomy with duraplasty was performed. The postoperative course after the second operation was uneventful. Hematological tests revealed a diagnosis of factor V Leiden. The patient was discharged with left hemiparesis and GCS of 15. To the best of our knowledge, no such clinical picture of MCA infarction after EG excision has been described before. Neurosurgeons should be aware of inherited thrombophilias, such as factor V Leiden, if the postoperative clinical course worsens because of cerebral artery thrombosis. Also, decompressive hemicraniectomy could be life saving and should be performed urgently without any hesitation. Keywords : Decompressive hemicraniectomy, Eosinophilic granuloma, Factor V Leiden, Middle cerebral artery stroke
Corresponding author : Erhan Arslan, arserhan@gmail.com