Pediatric Opioid-Use-Associated Neurotoxicity with Cerebellar Edema: A Case of POUNCE Syndrome Following Vein of Galen Aneurysm Treatment

We report the case of a 4‑year‑old child who experienced rapid neurological decline following opioid administration during anesthesia for an interventional procedure to treat a vein of Galen aneurysm. Cerebral magnetic resonance imaging (MRI) revealed marked cytotoxic edema in both cerebellar hemisp...

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Bibliographic Details
Main Author: Maxime Goldfinger
Format: Article
Language:English
Published: Ubiquity Press 2024-11-01
Series:Journal of the Belgian Society of Radiology
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Online Access:https://account.jbsr.be/index.php/up-j-jbsr/article/view/3786
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Summary:We report the case of a 4‑year‑old child who experienced rapid neurological decline following opioid administration during anesthesia for an interventional procedure to treat a vein of Galen aneurysm. Cerebral magnetic resonance imaging (MRI) revealed marked cytotoxic edema in both cerebellar hemispheres and the brainstem, indicative of opioid‑induced neurotoxicity. A follow‑up MRI, performed 2 weeks later, showed profound cerebellar and brainstem atrophy and showed reduction in mass effect due to cytotoxic edema. Teaching point: Pediatric opioid‑use‑associated neurotoxicity with cerebellar edema (POUNCE) syndrome is a rare condition, characterized by cerebellar edema as a hallmark feature, which can be identified on MRI in pediatric patients following opioid use.
ISSN:2514-8281