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Case Studies | Anaesthesiology | Slovakia | Volume 12 Issue 9, September 2023
Rare Complication in a Middle Age Child with Pilocytic Astrocytoma: A Case Report
Abstract: Background: Brain tumors are the most prevalent type of solid malignancy among paediatric patients. Pilocytic astrocytoma (PCA), often discovered in the posterior fossa, is the most frequently encountered juvenile cerebral tumor. Although malignant progression is uncommon, this gradually developing neoplasia can present with a wide range of complications. Brainstem compression and hydrocephalus, both of which have the potential to be fatal, may be present in these patients and require urgent intervention. However, external ventricular drain (EVD)-associated ventriculitis may present in a minority of these patients and lead to neuroinfection with associated neurologic sequelae. Source control and total surgical resection of the neoplasm along with antibiotic therapy are often considered the cornerstone of therapy. Case presentation: We present the uncommon case of a 7-year-old white boy who was admitted to the hospital due to vomiting, severe headache and convulsions. CT scan of the brain showed a large cystic lesion with a bright mural nodule in the posterior fossa of the brain. Likewise, compression of the adjacent structures along with obstructive hydrocephalus and cerebellar herniation were the most worrisome radiographic findings. Following this, an EVD was immediately placed. The therapeutic regimen consisted of dexamethasone, mannitol, sodium chloride, moxastine teoclate, metoclopramide, vancomycin, paracetamol, metamizole, tramadol and phenobarbital. Conclusion: Children are most likely to develop this low-grade and often well-circumscribed tumor, which generally has a favorable prognosis. However, prompt detection and early surgical excision can significantly reduce neurological impairment and improve quality of life.
Keywords: Pilocytic astrocytoma, External ventricular drain, Ventriculitis, Cerebrospinal fluid, Staphylococcus epidermidis
Edition: Volume 12 Issue 9, September 2023,
Pages: 341 - 343