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

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.