{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:48:37Z","timestamp":1792259317792,"version":"4.4.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Pediatric cerebral vasospasm (PCV) is associated with aneurysmal subarachnoid hemorrhage (aSAH), but aSAH is uncommon in children. No universal guidelines exist for PCV management. The authors sought to assess variations in practice patterns in pediatric aSAH and PCV management.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>A REDCap survey was circulated by the AANS\/CNS Pediatric Section and the Pediatric Neurocritical Care Research Group assessing PCV management practices.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 58 responses were received. The proportion of responses received from each region ranged from 19% in the Northeast to 28% in the Midwest. Of all respondents, 88% reported practicing at academic institutions. Neurosurgeons constituted 79% of respondents, and intensivists 17%; 85% primarily managed children. Most providers treated 1\u20133 aSAHs annually and a minority (21%) reported protocolized aSAH management at their centers. PCV prevention used permissive hypertension (90%), chemoprophylaxis (86%), and strict fluid-volume management (83%). PCV was typically assessed using serial neurological examination (60%) and transcranial Doppler (TCD) studies (72%). Treatment of PCV included permissive hypertension (50%) and endovascular interventions (81% intraarterial verapamil, 35% nitroprusside, and 67% angioplasty). Balloon angioplasty was more common than stent retriever\u2013plasty.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Pediatric PCV is rare and primarily treated by specialists at academic institutions. Although some elements of management are commonly used, wide variability exists in the strategies used for PCV prevention, detection, and treatment. Management strategies for pediatric PCV may be extrapolations from adult paradigms, but standardized guidelines are lacking. Prioritization should be given to the development of such guidance to enable the development of more robust evidence-based practices in the future.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.6.peds2439","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T02:29:49Z","timestamp":1731724189000},"page":"1-9","source":"Crossref","is-referenced-by-count":3,"title":["Variations in the management of pediatric cerebral vasospasm"],"prefix":"10.3171","author":[{"given":"Nicholas S.","family":"Szuflita","sequence":"first","affiliation":[{"name":"Monroe Carell Jr. Children\u2019s Hospital, Division of Pediatric Neurosurgery, Vanderbilt University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silky","family":"Chotai","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;"},{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, Children\u2019s of Alabama, University of Alabama Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Dornoff","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather C.","family":"Grimaudo","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Haley","family":"Vance","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr. Children\u2019s Hospital, Division of Pediatric Neurosurgery, Vanderbilt University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori C.","family":"Jordan","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Froehler","sequence":"additional","affiliation":[{"name":"Cerebrovascular Program, Vanderbilt University Medical Center; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Wellons","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr. Children\u2019s Hospital, Division of Pediatric Neurosurgery, Vanderbilt University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Dewan","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr. Children\u2019s Hospital, Division of Pediatric Neurosurgery, Vanderbilt University Medical Center;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Stroke","first-page":"1963","article-title":"Defining vasospasm after subarachnoid hemorrhage: what is the most clinically relevant definition?","volume":"40","author":"Frontera JA","year":"2009","unstructured":"Frontera JA, Fernandez A, Schmidt JM,  Defining vasospasm after subarachnoid hemorrhage: what is the most clinically relevant definition? 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