# Intraoperative Cerebellar Ischemic Stroke During Scoliosis Correction Surgery in a Pediatric Patient: A Case Report

## TL;DR

A 14-year-old girl with cerebral palsy and scoliosis experienced a cerebellar stroke during surgery, highlighting the need for better monitoring and research.

## Contribution

This case report highlights a rare intraoperative cerebellar stroke in a pediatric patient and emphasizes the importance of monitoring and communication during scoliosis surgery.

## Key findings

- A cerebellar ischemic stroke occurred during scoliosis correction surgery in a pediatric patient.
- The patient showed no functional deterioration despite the stroke, suggesting possible compensatory mechanisms.
- The case underscores the need for prospective studies on intraoperative stroke risks in pediatric scoliosis surgery.

## Abstract

We present the case of a 14-year-old female patient with cerebral palsy, spastic hemiparesis, and neuromuscular scoliosis. Her medical history includes scoliosis managed with a growing rod lengthening system in 2020 (at age 9), followed by a spinal lengthening procedure one year later. The patient underwent scoliosis correction surgery in 2025. During the procedure, she experienced a loss of somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP). A subsequent postoperative brain magnetic resonance imaging (MRI) revealed a cerebellar ischemic stroke, contrasting with a normal preoperative brain MRI. Despite this, she showed no functional or neurological deterioration compared to her baseline status. This case is notable for the occurrence of the cerebrovascular accident (CVA) during surgery, which prompted investigation into potential causes, such as global hypoperfusion by monitoring intraoperative vital signs. It also highlights the importance of rigorous monitoring and multidisciplinary communication during scoliosis surgery and suggests the need for prospective studies to evaluate the incidence and risk factors for intraoperative stroke in pediatric patients.