Novel application of the NeVa VS device in the management of severe vasospasm after meningitis

Cerebral vasospasm is a reversible narrowing of intracranial arteries that most commonly occurs after aneurysmal subarachnoid hemorrhage but can also result from central nervous system infections. Infectious vasospasm poses unique therapeutic challenges, as traditional medical and endovascular interventions are not well established in this context. This report presents a case of severe infectious vasospasm following bacterial meningitis and subdural empyema treated successfully with the NeVa VS retrievable stent device. A male in his twenties developed progressive hemiparesis and vasospasm of the right supraclinoid internal carotid and middle cerebral arteries, confirmed on angiography. Initial intra-arterial verapamil provided only a transient improvement. Due to hemodynamic instability, endovascular angioplasty was performed using the NeVa VS retrievable stent, resulting in restored vessel caliber and cerebral perfusion. The patient subsequently underwent empyema evacuation and showed significant neurological recovery. This case demonstrates the feasibility and potential benefit of retrievable stent angioplasty for refractory infectious cerebral vasospasm, extending the utility of the NeVa VS device beyond its established role in aneurysmal subarachnoid hemorrhage-related vasospasm.