Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience
BackgroundCraniopharyngioma (CP), although slow growing and histologically benign, has high morbidity, mostly related to hypothalamus-pituitary dysfunction and electrolyte imbalance. Increased risk of vascular complications has been described. However, data are still poor, especially in the paediatr...
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1292025/full |
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| author | Barbara Castelli Barbara Castelli Mirko Scagnet Federico Mussa Lorenzo Genitori Iacopo Sardi Stefano Stagi Stefano Stagi |
| author_facet | Barbara Castelli Barbara Castelli Mirko Scagnet Federico Mussa Lorenzo Genitori Iacopo Sardi Stefano Stagi Stefano Stagi |
| author_sort | Barbara Castelli |
| collection | DOAJ |
| description | BackgroundCraniopharyngioma (CP), although slow growing and histologically benign, has high morbidity, mostly related to hypothalamus-pituitary dysfunction and electrolyte imbalance. Increased risk of vascular complications has been described. However, data are still poor, especially in the paediatric population. The aim of our study was to evaluate the occurrence, timing, and predisposing factors of deep venous thrombosis (DVT) and other vascular alterations in neurosurgical paediatric CP patients.Materials and MethodsIn a single-centre, retrospective study, we investigated 19 CP patients (11 males, 8 females, mean age 10.5 ± 4.3 years), who underwent neurosurgery between December 2016 and August 2022, referred to Meyer Children’s Hospital IRCCS in Florence.ResultsFive patients (26.3%) presented vascular events, which all occurred in connection with sodium imbalances. Three DVT (two with associated pulmonary embolism, in one case leading to death) developed in the post-operative period, most frequently at 7-10 days. Elevated D-dimers, a reduced partial activated thrombin time and a prolonged C-reactive protein increase were highly related to thrombotic vascular events. One case of posterior cerebral artery pseudoaneurysm was described soon after neurosurgery, requiring vascular stenting. Superficial vein thrombophlebitis was a late complication in one patient with other predisposing factors.ConclusionCP patients undergoing neurosurgery are at risk of developing DVT and vascular alterations, thus careful follow-up is mandatory. In our study, we found that the phase of transition from central diabetes insipidus to a syndrome of inappropriate antidiuretic hormone secretion may be a period of significant risk for DVT occurrence. Careful vascular follow-up is mandatory in CP-operated patients. |
| first_indexed | 2024-04-24T11:22:31Z |
| format | Article |
| id | doaj.art-79079a40857f45e6ae241df30dde08e4 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-24T11:22:31Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-79079a40857f45e6ae241df30dde08e42024-04-11T04:27:13ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922024-04-011510.3389/fendo.2024.12920251292025Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experienceBarbara Castelli0Barbara Castelli1Mirko Scagnet2Federico Mussa3Lorenzo Genitori4Iacopo Sardi5Stefano Stagi6Stefano Stagi7Department of Health Sciences, University of Florence, Florence, ItalyNeuro-oncology Department, Meyer Children’s Hospital IRCCS, Florence, ItalyNeurosurgery Department, Meyer Children’s Hospital IRCCS, Florence, ItalyNeurosurgery Department, Meyer Children’s Hospital IRCCS, Florence, ItalyNeurosurgery Department, Meyer Children’s Hospital IRCCS, Florence, ItalyNeuro-oncology Department, Meyer Children’s Hospital IRCCS, Florence, ItalyDepartment of Health Sciences, University of Florence, Florence, ItalyStruttura Organizzativa Complessa (SOC) Diabetology and Endocrinology, Meyer Children’s Hospital IRCCS, Florence, ItalyBackgroundCraniopharyngioma (CP), although slow growing and histologically benign, has high morbidity, mostly related to hypothalamus-pituitary dysfunction and electrolyte imbalance. Increased risk of vascular complications has been described. However, data are still poor, especially in the paediatric population. The aim of our study was to evaluate the occurrence, timing, and predisposing factors of deep venous thrombosis (DVT) and other vascular alterations in neurosurgical paediatric CP patients.Materials and MethodsIn a single-centre, retrospective study, we investigated 19 CP patients (11 males, 8 females, mean age 10.5 ± 4.3 years), who underwent neurosurgery between December 2016 and August 2022, referred to Meyer Children’s Hospital IRCCS in Florence.ResultsFive patients (26.3%) presented vascular events, which all occurred in connection with sodium imbalances. Three DVT (two with associated pulmonary embolism, in one case leading to death) developed in the post-operative period, most frequently at 7-10 days. Elevated D-dimers, a reduced partial activated thrombin time and a prolonged C-reactive protein increase were highly related to thrombotic vascular events. One case of posterior cerebral artery pseudoaneurysm was described soon after neurosurgery, requiring vascular stenting. Superficial vein thrombophlebitis was a late complication in one patient with other predisposing factors.ConclusionCP patients undergoing neurosurgery are at risk of developing DVT and vascular alterations, thus careful follow-up is mandatory. In our study, we found that the phase of transition from central diabetes insipidus to a syndrome of inappropriate antidiuretic hormone secretion may be a period of significant risk for DVT occurrence. Careful vascular follow-up is mandatory in CP-operated patients.https://www.frontiersin.org/articles/10.3389/fendo.2024.1292025/fullpaediatric neuro-oncologycraniopharyngiomadeep venous thrombosisvascular complicationsneurosurgery |
| spellingShingle | Barbara Castelli Barbara Castelli Mirko Scagnet Federico Mussa Lorenzo Genitori Iacopo Sardi Stefano Stagi Stefano Stagi Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience Frontiers in Endocrinology paediatric neuro-oncology craniopharyngioma deep venous thrombosis vascular complications neurosurgery |
| title | Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience |
| title_full | Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience |
| title_fullStr | Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience |
| title_full_unstemmed | Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience |
| title_short | Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience |
| title_sort | vascular complications in craniopharyngioma resected paediatric patients a single center experience |
| topic | paediatric neuro-oncology craniopharyngioma deep venous thrombosis vascular complications neurosurgery |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1292025/full |
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