Perinatal arterial ischemic stroke related to carotid artery occlusion

Autor: Stéphane Chabrier, Frédéric Villega, Stephanie Garcia-Tarodo, Joel Victor Fluss, Sébastien Lebon, Béatrice Husson, Solene Ferey, Manoelle Kossorotoff, Vincent Muehlethaler, Michèle Granier
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Placenta/pathology
Magnetic resonance angiography
Brain ischemia
03 medical and health sciences
Intellectual Disability/etiology
Stroke/diagnostic imaging/etiology
0302 clinical medicine
Cerebral Palsy/etiology
Pregnancy
Risk Factors
030225 pediatrics
Internal medicine
medicine
Humans
cardiovascular diseases
Thrombus
Carotid Arteries/diagnostic imaging
Stroke
Arterial Occlusive Diseases/complications/diagnostic imaging
Carotid Artery Diseases/complications/diagnostic imaging
ddc:618
medicine.diagnostic_test
business.industry
Infant
Newborn
General Medicine
Brain/diagnostic imaging
medicine.disease
Brain Ischemia/diagnostic imaging/etiology
Cerebral Angiography
Epilepsies
Partial/etiology
Developmental Disabilities/etiology
Carotid artery occlusion
Pediatrics
Perinatology and Child Health
Arterial Occlusive Diseases
Etiology
Cardiology
Female
Neurology (clinical)
business
Magnetic Resonance Angiography
030217 neurology & neurosurgery
Cerebral angiography
Zdroj: European Journal of Paediatric Neurology, Vol. 20, No 4 (2016) pp. 639-48
ISSN: 1090-3798
Popis: Background The aetiology of perinatal arterial ischemic stroke remains speculative. It is however widely accepted that the aetiology is multifactorial, involving various maternal, placental, foetal and neonatal risk factors. A resulting thromboembolic process is hypothesized and the placenta identified as the most plausible source. An arteriopathy, as observed in a significant proportion of childhood ischemic stroke, is thought to be rare. Methods We report here five cases of perinatal stroke that differ from the vast majority by documented carotid occlusion, and add eleven other similar cases from the literature. Results In the majority, an intraluminal thrombus of placental origin is the most probable hypothesis, while in the remaining ones, one can reasonably presume a direct vessel wall injury related to a traumatic delivery, yet generally unproven by imaging. Conclusion We hypothesize that most of these cases share similar pathophysiology with the more common perinatal arterial ischemic stroke but differ by a persistent identified thrombus in the carotid artery at the time of first imaging, leading to a more severe and extended ischemic damage responsible for an adverse neurological outcome.
Databáze: OpenAIRE
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