Repetitive navigated transcranial magnetic stimulation to facilitate motor rehabilitation in acute pediatric hemorrhagic stroke - illustrative case.

Maximilian Schwendner, Haosu Zhang, Leonie Kram, Mohammed Issa, Ahmed El Damaty, Sandro M Krieg, Sebastian Ille

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Article in Brain & spine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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7 authors.

Maximilian SchwendnerDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Haosu ZhangDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Leonie KramDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Mohammed IssaDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Ahmed El DamatyDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Sandro M KriegDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Sebastian IlleDepartment of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University, Heidelberg, Germany.

Funding

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6 · The paper itself

Abstract

Background: Hemorrhage from arteriovenous malformations (AVMs) represents the most frequent cause of pediatric hemorrhagic stroke. However, outcomes often bear permanent extensive neurological impairments. Observations: An eleven-year-old male presented to the emergency department following a sudden onset of left-sided hemiparesis and continued loss of consciousness after an epileptic seizure. Imaging revealed a large hemorrhagic stroke of the right frontal lobe resulting from bleeding of an arteriovenous malformation. After microsurgical resection, low-frequency repetitive navigated transcranial magnetic stimulation (nrTMS) therapy targeting the motor hotspot of the unaffected hemisphere was administered. At the 4-month follow-up visit, the patient recovered motor function, with persisting minor deficits in leg mobility and a predominantly distant arm paresis. Lessons: Utilizing nrTMS in pediatric patients effectively assessed motor function and in addition potentially contributed to early-stage motor rehabilitation. This method marks a potential advancement in acute pediatric stroke management.

Indexed as

Arteriovenous malformationNeuromodulationPediatric strokeRepetitive transcranial magnetic stimulation

Identifiers

PMID40994523

DOI10.1016/j.bas.2025.104397

PMCPMC12455120

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